“The procedures we do here routinely are game-changers, yet many people don’t know about them,” says Rami Kaldas.
The conversation begins with the numbers 5 and 9.5.
“The first number is the average number of physicians women must see before their endometriosis is diagnosed,” said gynecological surgeon and obstetrician Dr. Rami Kaldas. “The second represents the average number of years before that diagnosis is rendered.”
Understand that the second figure does not include treatment of the issue, which easily bumps the number of years into double figures.
As these staggering statistics take root in the mind, Kaldas then discusses – calmly, almost quietly, and with obvious compassion – the women traveling this path and who eventually find their way to Appleton’s Kaldas Center for Fertility, Surgery & Pregnancy.
“While every single patient is different, their stories share a common theme,” said Kaldas. “Over and over again these women have been told that they can’t be helped.”
Kaldas built his practice and reputation on helping women who have heard again and again there is nothing to be done. Regardless of the issues, something can be done.
Providing care in the area since 1996, Kaldas’ journey to the Fox Valley has covered serious mileage. Born in Egypt, raised in Charlotte, educated at Duke, trained at Stanford, Kaldas left Palo Alto to join the bustling practice of Drs. Ron Strebel and Fred Bartizal in Neenah.
His training at the world-renowned Stanford University Medical Center included being taught by Dr. Camran Nezhat, the physician who invented video and laser laparoscopy. Learning from the pioneer and leading practitioner in the field of laparoscopic surgery provided Kaldas with a singular and profound proving ground for techniques that were so cutting edge they were dismissed by many as gimmicks.
“Camran Nezhat was my mentor at Stanford and the first to describe a lot of the procedures I do,” said Kaldas. “Where he went, others would follow. But he was the trailblazer.”
Kaldas cites his experiences with Nezhat at Stanford University School of Medicine, one of the most prominent academic medical schools in the country, for delivering him to a place where he feels comfortable performing procedures that others cannot or will not attempt for their patients.
Kaldas has performed more than 5,000 minimally invasive laparoscopic procedures for endometriosis, which affects 10-15% of women of childbearing years. His training puts him in the position of often being the only surgeon who will perform certain procedures for his patients.
Once routinely dismissed as simply part of being a woman, endometriosis was cited in a recent study as one of the ten most painful medical conditions. Unfortunately, the tendency to present the symptoms of the disease as something that should be stoically endured persists, said Kaldas, who sees women every day suffering from the painful and debilitating effects of endometriosis made more devastating by a frustrating – and sometimes humiliating – search for answers.
He describes the patient journey to Kaldas Center in simple yet profound terms:
“Imagine you were a person who was having challenges, many long years in duration. And it was an enigma to you. Like you’re in a cloud and you are feeling your way around because you can’t see a thing. And after an hour here, you have clarity; and when you are done, the skies are clear.”
Kaldas’ skills in the treatment of endometriosis has made his center a destination for women not only in the region but also for women across the country. The Kaldas Center is the only Wisconsin provider and one of only 50 in the nation recommended on Nancy’s Nook, a private, invitation-only Facebook page devoted to endometriosis.
“I see patients weekly that come from great distances to get the treatment they feel they’ve been denied elsewhere,” said Kaldas.
Dr. Kaldas’ residency created a foundation which most residency programs no longer provide. His foundation has allowed him to not only serve many patients with challenging situations but also to teach and guide other professionals.
Another issue treated regularly – and innovatively – at Kaldas Center is female urinary incontinence, which happens to 40% of women who give birth. As with endometriosis, incontinence is often described to patients as something that just happens to women who have had children, and that’s the end of it.
Kaldas has seen the effects this “diagnosis” and how letting the condition go untreated literally forces women to conduct their lives around it.
“These women have to immediately scope out bathrooms in every public situation,” said Kaldas. “They don’t go on vacations because of it. Due to their embarrassment, they don’t tell their husbands, and when they finally work up the gumption to tell someone about it because they are so miserable, they get the same speech about it being part of the female experience.
To change their lives, Kaldas performs a non-mesh procedure known as a burch. And Kaldas is one of the few physicians in Wisconsin that does it.
“I’ve done hundreds of these procedures,” said Kaldas. “Takes a half an hour to perform, no device is needed – just four sutures – and the patient goes home an hour after that.”
Kaldas emphasizes the importance of yearly exams and consider these the foundation of the practice. It is here that relationships are forged, where women who have suffered – often in silence – are finally heard.
“These are powerful opportunities for women,” said Kaldas. “They’ve saved up their issues for a year and are ready to dump them, and the exam leads to ‘we’re going to fix your leaking,’ ‘we’re going to fix your pain,’ ‘what else is going on’ and ‘let’s take care of it.’”
Word of mouth, especially in the digital age, is an effective tool. A plethora of sites and platforms now exist to bring understanding, clarity, and compassion to women’s care issues traditionally relegated to hushed conversations that when courageously amplified were met with dismissive platitudes. Despite the positive trajectory of the discussion, Kaldas continues to see patients who have heard their issues cannot be fixed, that there is simply nothing to be done.
“Nonsense!” says Kaldas emphatically. “We do these things every day. And they are life changing.”
NOTE: NOVO Health recently announced the Kaldas Center for Fertility, Surgery & Pregnancy – recognized experts in the use of laser treatment to excise endometriosis – joined NOVO Health as a provider of women’s health services. NOVO Health will make available to its self-insured employer partners an episode of care bundle for the treatment of endometriosis through the Kaldas Center beginning April 1, 2019.