Tuesday, July 7, 2015

Postpartum Body Expectations



 
Recently, my husband got a big lecture from me. We were at the park and walked by a couple with a new baby (probably 1-2 months old). After we were out of earshot he remarked, “Look at that lady, a new baby and she’s already pregnant again!” I turned to stare at him, and when I realized he was serious, the lecture commenced. That woman wasn’t pregnant again! She had a new baby! That’s what your body looks like after you have a baby! To be fair to my husband, he has no experience with babies or pregnant women. Like many men (and women) his ideas of what a “post-baby body” looks like come from television and magazines. And there lies the problem. The whole world sees these celebrities with headlines cheering them for getting back to their pre-baby body in just a couple of weeks – and unfortunately this is negatively affecting new moms. Remember a couple of years ago when Duchess Kate had Prince George and she came out of the hospital still sporting a bump? There was a huge outcry of support that finally someone was showing what is normal after childbirth. I want to see more of that! Unfortunately, that’s the only time I can think of a celebrity showing off their normal body after baby.


Here’s the truth. It took your body 9 months to change into the condition it is in postpartum and it doesn’t and shouldn’t go back overnight. We have to change this idea or expectation through education because women are actually doing damage to their bodies by trying to achieve this cultural “norm.”
I have women who I see a few months postpartum who are coming to me due to pelvic organ prolapse. Here’s something that needs to be understood. Your body needs rest after childbirth. Due to the hormone changes and all the pushing, your internal structures that support your organs are like warmed up taffy. 

This is important to understand. Women shouldn’t be returning to high impact activities, lifting heavy weights or doing other things (Oh God, not burpees!) that can damage their bodies! I have women who have done just that. Moving 2 days after delivery and lifting heavy boxes. Returning to Crossfit 2 weeks after delivery.  Part of this is due to a lack of education about the importance of letting your body rest. The other part is due to feeling like they are expected to get back to their pre-baby weight/body ASAP.

So here it is straight from the horse’s mouth. If you have just given birth, you have permission to rest. Take care of yourself and your newborn. There will be time for getting back to your exercise regime, but it’s not in the first 6 weeks. Please take care of your body! It’s the only one you’ve got! I recommend seeing a pelvic PT for education and instruction in safe return to exercise postpartum. 

And FYI, my husband now has a very good understanding of what happens during pregnancy and afterward and what he can expect if we ever have children. He won’t be making that mistake again!

Monday, June 15, 2015

Spreading the word for Pevic PT!

I'm so proud to be a part of a team that is passionate about educating other healthcare professionals about pelvic PT! We were recently published in Women's Healthcare - a clinical journal for Nurse Practitioners. Check out the article here.

Friday, March 20, 2015

Interview with Lorraine Faehndrich, Pelvic Pain Relief Coach



I'm excited to bring you this interview with Lorraine Faehndrich who is a Mind-Body Coach who is helping women with vulvodynia and other pelvic pain syndromes.  

WUDT: So, how did you get into helping women with pelvic pain?


Lorraine: I got started because I experienced pelvic pain myself. Previously, I was a life coach and massage therapist and I was fascinated by how the mind and body work. I had also studied nutrition and gone to naturopathic college. Then a couple of years ago I had issues with pelvic pain and I healed it by communicating with my body. I had previously healed some other health issues I was having by listening to my body and what it had to say and so I decided to try that with my pelvic pain.  Within 6 months I was healed.  So afterwards, I did mind-body training and was attracted to working with women with pelvic pain and decided to specialize in that.

WUDT: I feel that the mind-body component is a huge piece of the puzzle and I will admit that though I continue to learn more in this area, I sometimes feel limited. I give patients stress coping techniques and relaxation exercises and education on their bodies. I can definitely address the physical issues, like trigger points and muscle tension, but the mental component is harder to address. 

Lorraine: I feel that PT can be great when used in conjunction with a mind-body approach. Many of my clients have done PT or are in PT and feel they’ve gotten as much as they can out of it. For some women the issue is clearly and purely physical but for many women there is a lot more going on. A lot of underlying issues cause stress and tension including how they are dealing with their emotions. Our mind/body/emotion/soul system can’t be separated. It is all connected.  What happens with our emotions and our mind affects our body, and vice versa.  I find that women are very dissociated from their bodies and have been for a long time. Sometimes this is due to a trauma in their past or feeling emotionally not very safe. They need to develop mental and emotional coping strategies to help them with feeling safe and accepted. I think it can be a great opportunity when women are in PT to start tuning in and learning about their body.  Though the traditional medical approach typically doesn’t acknowledge it, there is emotion held in the body that can come up with stretching and relaxation and this is a great opportunity to work with that emotion.  

WUDT: It’s interesting that you mention that. I took a course earlier this year about chronic pain and they discussed how emotion gets stored in scars and if patients are having scar pain you should work on the scar and have them talk about it. For example, I had a patient who had a traumatic birth with vaginal tearing and afterward she had painful intercourse. We worked on her muscle tension and trigger points and her scar tissue and she got a lot better but she continued to have pain just in the area where her scar was. So I had her talk about her birth story, about what happened. No judgment, just what happened, while I did scar work. And the emotion started to come out about her fear during the birth and afterward about having more children. We did this for a few sessions and it really made a difference.  

Lorraine:  That is a perfect example.  There are so many emotions that women can hold in their body – about birth, about their relationships and work, their lives in general.  I also think we have a big cultural problem that may contribute to pelvic pain. Women walk around feeling shameful and bad and wrong about looking at and understanding this part of their body.  We are very disconnected from our pelvises in general, and learning how to reclaim this part of the body can definitely be part of the healing process. A big part of the work I do is helping women to be comfortable with being in their body and feeling their emotions. This allows the emotions to move through the body and not get caught in muscles. A lot of women hold emotional energy in their pelvis when they feel guarded and unsafe.

WUDT: It’s a fine line with explaining to patients that there is a mental and emotional component to their pain without them feeling like I’m just one more person telling them it’s all in their head. So many doctors have already told them that and they’ve been made to feel like they’re crazy.

Lorraine: I also hear that a lot and have to clarify that I know (firsthand) that the pain is very real. Everything that your mind creates is real. Pain isn’t in your head it’s in your body but that doesn’t mean that it’s not connected to what’s happening in your mind. Everything is very connected. If you think a thought, like I’m never going to get out of pain, your nervous system sends out signals and does things that affect your physiological function and create tension and this all affects your ability to heal. We definitely underplay the effects of the experiences in our lives and the ways we’ve learned to feel our emotions. This has a huge impact on tension and pain in particular. 

The work I do is based on the work of Dr. John E. Sarno who wrote The Mind Body Prescription. He worked with back pain patients and was a surgeon that recognized the underlying cause of the pain was emotional. He taught his patients that their pain was 100% emotional, even when x-rays showed a slipped disc or some other physical issue. He would tell them that other people have these same physical issues but don’t have pain as a result.  In other words, the physical issue isn’t what was causing the experience of pain.  He had a very high success rate.

There are two underlying causes.

The first is having repressed emotions that you’re not dealing with. We’re not aware when we’re not feeling emotions because our brain protects us from emotions it thinks are threatening. This can be due to experiencing something traumatic or living in an environment where we can’t cry or emotions aren’t welcome. Our brain learns to shut them down by using muscle tension to hold back the emotions and this sets off the fight or flight response, which creates more stress and tension

The other issue is that the brain is using pain as a distraction from our emotions and the issues in our lives that we are not addressing. The pain is a decoy because instead of being aware of the emotion or the issue, you are constantly worrying about pain and trying to fix the pain.

I have been successful with education on the mechanisms of pain and teaching clients how to come back into the body and feel sensations. The way to start feeling emotions is to start feeling what’s going on in your body. 

I also find that many women with pelvic pain are living out of alignment with their true self in some area of their life. In order to stay in a situation like that you have to suppress a lot of emotion. So we address the bigger mental and emotional issues that create the pain in the first place. Sometimes these can be personality traits like perfectionism or being super critical of ourselves and not connected to our bodies and not living the life we want to be living. Sometimes it comes from what we learn about our bodies.  We can walk around carrying a lot of shame, or beliefs about sex and marriage and what a woman’s role is that aren’t in alignment with who we are. I think pain can actually be a gift to get women to address the bigger things that are going on in their lives.  It was for me.

Lorraine Faehndrich works with women all over the United States by phone and through Skype internationally. She provides private coaching as well as a group class a couple of times per year over the phone. 

She is offering a free introductory tele-seminar on March 24th 

This free seminar will be followed by an 8 week program which will begin on April 14th and registration opens on March 24th.

Thursday, March 19, 2015

Spreading the Word

A couple of weeks ago I attended an event through MetroMoms where I got to spread the word about how beneficial postpartum pelvic floor physical therapy can be. It was exciting to hear how many women had heard of this type of PT from their friends and sisters, but there were still so many who didn't know this is an option.

That's one of the reasons I do these types of events and write this blog. I want to educate moms that issues like urinary incontinence, pain with intercourse and/or pelvic organ prolapse are not just the price they pay for having children. I think that in the US we unfortunately do a great disservice to mothers, in many areas. I've said this before, but in other countries the standard of care is to send a woman home with a baby and a prescription for pelvic PT. Why are we not doing the same thing in the US?

So education is absolutely vital whether that is in our communities, online, or to other healthcare providers. I'm doing my part, but I ask you to do the same. If you're a mom, bring it up with your girlfriends! Tell your own mother! Just letting someone know that there are options could really change their life and continue to spread the word!

Monday, February 9, 2015

You Should Yoga

I often recommend yoga to patients for a variety of reasons, including relaxation and stress management and for improved flexibility of tight muscle groups. I tend to be rather slack and lacking in my own yoga practice probably for the same reasons that others have, i.e. lack of time for classes. Let me just say that taking the time for yoga is SO worth it.

When I start my day with yoga I feel more calm and centered to tackle whatever comes at me that day. When I end my day with yoga I feel more relaxed and restful and get a great night's sleep. When I do yoga when I get home from work for the day it helps me to release the stress and tension of the day including road rage from sitting in traffic for an hour. It also helps me so much with posture. I have TERRIBLE posture! I know, I'm a PT and I always hound people about their posture - which is VERY important! But when you are working on things in front of you all day and on the computer and sitting all day, your posture can take a huge hit. Yoga reminds me to check in with my body and my position throughout the day so I can remember to keep myself in line. So, needless to say, I'm a fan of yoga. But the time can still be an issue, besides classes can be costly. So what's a girl to do?

I have found a great resource that I want to share with everyone. I have been doing Yoga With Adriene since last summer. She's an Austinite (bonus!) who has a website where she features FREE online yoga videos including a recent series of 30 days of yoga. I love her style of not being so rigid with poses but guiding you in becoming in tune with your body to understand what it needs. I highly recommend her site and she also has a YouTube channel which is where I first found her. For my followers in Austin, she also does local classes. For more, click below and enjoy!


Yoga With Adriene





Thursday, January 29, 2015

Health Activist Award Nomination

I have been nominated for a Health Activist Award for this blog! I am very excited and thank all of my readers and followers. Please consider going to the WEGO website to endorse me.

Endorse What's Up Down There

Endometriosis is the Devil - This time it's Personal

Wouldn't this blog title make an excellent movie title?

Whenever I think about endometriosis I think about Venom from Spiderman. For those of you who are not comic book nerds, Venom kind of takes over another person with this black, web-like material until ultimately they're engulfed. That's how I imagine endometriosis taking over the inside of the body. Evil stuff.

So this is the story of why endometriosis is the devil and why I became a pelvic floor therapist.


There is this woman I know, let's call her...Cody. She had a family history of endometriosis. She had always had really heavy menstrual cycles and when she was a teenager she developed ovarian cysts so she started taking birth control pills. All was fine in the "South" until she was in college. She noticed that she was depressed and generally felt "blah" in all areas of life. She tried many types of birth control including Ortho Evra, BeYaz, Nuva Ring, and Depo Provera injections but she just didn't feel like herself on these medications. So she finally decided to go off of them. She noticed that her periods gradually got heavier and more painful.



Then one day she had to have an abdominal surgery. She was left with what amounted to a C-section scar. All went well with the surgery but as time progressed her period became so painful it was debilitating. She was taking her pain medication that was prescribed for post-surgical pain for her menstrual cramps. She couldn't sleep and would lie in the fetal position at night crying because of her pain. It made her nauseous and she couldn't seem to get out of the fetal position without it feeling like someone was stabbing her in the uterus and vagina with a knife. Fun times, right?



So how is someone supposed to function like this? She was in college and could get by with missing class from time to time so she dealt with it as best she could. Until she graduated and realized she was going to be getting a real job, and how was she supposed to work like this? She couldn't call in to work every month because she was on her period. So she went to her gynecologist to figure out what was wrong. She was diagnosed with endometriosis and told she had two options. She could have laparascopic surgery to remove adhesions (that could just come back in a few months) or be put back on birth control. That was it. Those were the only options.Or so she was told.



This may be my story, but it is also very similar to all the stories I have heard from my patients who come in with a diagnosis of endometriosis. It is very unfortunate, but there are a lot of doctors out there who don't know that there is another option for treating this issue. I did my homework and research and found out that there was treatment available in the form of pelvic PT.

Okay, this part is coming from me as the woman with endometriosis, not me as a pelvic floor therapist: Endometriosis sucks, but pelvic PT has made an amazing difference. I can do so many things that I couldn't before without pain. It has helped my relationship, my mental health, and I don't dread my period every month. I feel normal and I have the tools to keep myself in good shape. If I don't use them because I'm feeling good, I remember the next month. I'm not cured (there is no cure for endometriosis) but I can manage my condition and live my life as a normal person.

If you are dealing with endometriosis please talk to your doctor about pelvic PT. It has made a huge difference in my life and the lives of my patients and it could make the difference for you too.