An Interview with James Haley, MD, FACOG, FPMRS
In order to become board-certified, and have that distinction, you have to do a tremendous amount of studying. In a sense, the certification forces you to become an expert. Generally speaking, OB/GYNs are trained in pelvic floor complications, but not nearly to the extent that’s required for FPMRS certification. Going through the sub-specialty training makes you realize what you didn’t know. It really advances not just your knowledge, but also makes you a much better surgeon in regards to your approach and your ability to take care of even the most difficult situations.
How has being a FPMRS (Female Pelvic Medicine and Reconstructive Surgery) specialist changed how you practice medicine?
Having three of us as FPMRS specialists distinguishes us as the go-to for women who need pelvic surgery.
When you offer patients pelvic repair procedures such as Vaginal Rejuvenation, how does that compare to ThermiVa, which is a less invasive?
ThermiVa is a non-surgical procedure for vaginal tightening, performed in the office. I think of ThermiVa as an option for women that may have issues with vaginal dryness or sexual dysfunction, some leakage, or some loss of support. However, when comparing the ThermiVa procedure to some aspects of vaginal reconstruction, they are not the same. If a patient’s issues aren’t too bad, ThermiVa can be a good option. The worse the problem, however, the more extensive surgical reconstruction the patient may require.
Is there a trend in GYN Surgery?
Over the next few years, it looks like reconstructive pelvic surgeries will no longer be performed by general OB/GYNs, either because they don’t want to or because they won’t be qualified. Instead, they’ll refer their patients to a specialist who has earned this board distinction. This trend has already happened in a number of fields, with the sub-specialty of FPMRS being one of the most recent ones.
Additionally, as the population ages, we’re seeing pelvic floor problems more and more. The number one reason for issues with prolapse is delivering babies vaginally and having them come out through the birth canal. These aren’t necessarily births that have complications, but it’s just fallout from regular deliveries where babies come through and stretch–and often damage–the muscles and tissue.
In addition to childbirth, there are other things that contribute to loss of pelvic floor support, including jobs that involve lots of lifting and/or heavy straining. Other people who have experienced the loss of pelvic floor support include long-term smokers, people who are overweight and even athletes who compete extensively in high-performance activities.
Recently, you have gotten interested in ALCAT [food sensitivity] testing. What is it, and what drew you to learning more about ALCAT?
The ALCAT test (antigen leukocyte antibody test) measures negative reactions to the food we put in our bodies. I got interested because I was seeing patients having health issues, and no amount of regular testing was showing any kind of helpful results. Becoming a subspecialist in Female Pelvic Medicine has factually pushed me to a new level of knowledge for my patients –surgically, and in other areas as well.
Is there a correlation between food sensitivity picked up from an ALCAT test and gynecological issues?
A lot of “hormonal” issues can actually be related to food sensitivities.
I hear patients discuss things like hormone imbalances, weight gain and depression all the time. Sometimes there’s a gynecological cause. But sometimes, there’s an interplay of other things. And what I’ve come to realize is it’s often the combination of underlying issues that’s the source of the problem.
As an OB/GYN, I see women every day who tell me the problems they’re experiencing, and yet sometimes there hasn’t been this simple, easy resolution. This is especially the case with patients who use their OB/GYN as their primary care provider and don’t see an additional doctor. A woman will come in for her yearly exam and mention she’s just not able to lose weight, or that nothing she’s tried is working. If we check standard things and find nothing is working, what’s missing? Then I know it’s time to move onto something else.
An ALCAT test is the only reliable test that can discover these types of things in the blood. They are used worldwide, and a lot of athletes use ALCAT tests to try to give themselves an edge in performance.
What exactly is a food sensitivity?
Our bodies react when they come in contact with toxins in our food, such as chemicals, dyes, or pesticides. When you talk about our immune system, there are two parts: one is when our bodies come into contact with a particular food; there can be an immediate allergic reaction that many people are familiar with. (For example, peanuts, shellfish, etc.) But the second part, called the Innate Immune System, is when we come into contact with foods that create a delayed response. This response can occur within a day, several days, or even a week. We don’t realize the connection, and sometimes we don’t even notice.
So, if we’re putting things into our body, and the body recognizes it as an “intruder,” our bodies send out an “attack” response to this particular type of food or substance. Food responses are responsible for numerous related health issues.
Some of the biggest health issues have been linked to these types of responses, including heart disease, diabetes, complications with weight and obesity, chronic fatigue, bowel issues, depression, ADHD, and it just goes on and on. The commonality behind a lot of those diseases is inflammation. The body mounts an inflammatory response when it comes into contact with something it doesn’t recognize, and over time, that causes issues in the body.
Years ago, we thought our bowel was responsible for only 20 percent of the immune function. Now they realize 80 percent of our immune system is related to the bowel. So now, the bowel is the primary immune function. Given that change in percentage, a lot of problems can be connected to that.
How does the ALCAT test work?
A patient can choose by picking up a number of panels what they want to be tested for. The panel gets sent off and they get a very detailed result indicating what foods are okay to eat, what foods are triggering a mild reaction, and what foods are triggering a severe response and should be avoided. The company that administers the ALCAT test will also help the patient with a rotation diet to help their body recover from the inflammatory-triggering foods.
Are there any references you recommend to patients if they’re interested in learning more about it?
Patients can visit the ALCAT website. It’s pretty helpful. I actually created my own brochure about ALCAT testing so that when patients ask about it, they can read the information and get a much better understanding of what the test involves and what might be a result of what they’re experiencing. If a patient shows interest in the test, I’m happy to sit down with them and send them home with additional information.
Down Time
You’re a big participant in marathons, and even a few triathlons. What else do you enjoy doing in your spare time?
I like traveling and spending time with my family. I also enjoy golfing and hiking.
