Saturday, April 12, 2014

Blog About Pelvic Pain

I have been on a brief hiatus from writing due to being in charge of a fundraising walk. It's been a busy month for me, but I am going to be back posting soon. In the mean time, I have some new reading material for you! My co-worker and friend Sara Sauder, PT, DPT has recently launched her own blog specifically about pelvic pain. It's going to be a great resource for those dealing with pelvic pain. Go check it out!

Blog About Pelvic Pain

Monday, March 3, 2014

Q & A About Urogynecology

Diagnoses that contribute to pelvic pain, such as interstitial cystitis and vulvodynia are challenging to manage. A collaborative approach among healthcare providers is in the best interest of patients. It is important to find not only a skilled physical therapist, but other skilled providers as well. In keeping with the recent theme of Q & A, here's an interview with Audrey Baum, Certified Women’s Health Care Nurse Practitioner, working with Dr. Tomas Antonini at Central Texas Urogynecology and Continence Center. Audrey has been a great resource and great collaborator with our clinic and here is a little peek into her practice.

What's Up Down There (WUDT): What diagnoses does your practice treat the most?
Audrey Baum, WHNP

AB: We primarily treat urinary incontinence and pelvic organ prolapse. We also treat fecal incontinence, interstitial cystitis, recurrent UTIs, recurrent vaginal infections, most types of sexual dysfunction and vulvar vestibulitis/vulvodynia.

WUDT: What are the different treatment options available to patients for IC?

AB: Treatments center on diet modification, stress management, pain management and medication. All treatment plans are customized to fit individual patient needs. Diet modification includes instruction on IC-friendly diets, identifying personal dietary triggers and developing a diet that fits with the patient’s lifestyle.

Stress management is essential and we focus on finding exercise or meditative programs that work for the patient, as well as counseling when needed. We stress non-narcotic management of pain and focus on flare/trigger control and physical therapy with experienced therapists. Mild non-narcotic pain relievers are prescribed infrequently (we refer to pain management specialists if stronger pain relief is needed).

We also offer in-office bladder installations for times when immediate pain relief is required and can instruct the patient on how to do these at home, if needed. Cystoscopy with hydrodistention is a procedure done in the OR that can sometimes relieve pain symptoms for several weeks or months.

Medication includes Elmiron and other aids to control bothersome IC bladder symptoms, including overactive bladder medications. Patients with severe symptoms unrelieved by these measures can try InterStim, an implanted nerve modulator, or Botox.

WUDT: Does your practice treat vulvar vestibulitis, and if so what treatments are available?

AB: Yes. Treatment is individualized and includes many of the same areas as IC. We focus on non-narcotic pain relief, including commercial and compounded topical medications or suppositories and hot/cold therapy. We refer to physical therapy as appropriate.

WUDT: What do you like best about practicing in urogynecology?

AB: Changing people’s lives! We give patients back their ability to sit through a movie, walk without pain, exercise without wearing a pad, shop without memorizing bathroom locations and have sex without discomfort. It is very rewarding to hear how happy people are (we see lots of joyful tears).

WUDT: What is the most challenging part of practicing in urogynecology?

AB: Managing chronic pain. It is a frustrating problem for both us and our patients.

WUDT: What started your interested in urogynecology?

AB: I stepped in to help out a urogynecologist for six weeks while her physician's assistant was in China adopting a baby and I fell in love with the specialty. That was eight years ago and I haven’t looked back.
Thanks to Audrey Baum, WHNP and Sara Sauder, PT, DPT for their collaboration on this article!


Monday, February 17, 2014

Ask me anything!

I'd like to start this new year off asking for some input from my readers. What do you want to know? Do you have questions that you are too embarrassed to ask your doctor or other health care professionals? Do you need answers about your pelvic floor but don't have a pelvic floor therapist? I would love to answer your questions (to the extent possible without examining you!)! Go to the contact tab on this page and send me an email. All those posing questions will remain anonymous.

Friday, February 7, 2014

Why Am I a Pelvic Floor Physical Therapist?

This is a question I get asked regularly. It's usually said in some version of "I don't want to offend you, and I'm happy that you do, but why in the world would you want to do this type of therapy?" It's a valid question. I do rectal and vaginal exams or treatments on a daily basis. If I'm not doing some sort of internal treatment, then I am placing electrodes around your anus. Given that, I can't say that its the most glamorous job around. But I love my job. I get to help people who have been suffering for years and I am able to give them not only hope, but results. You get used to treating that "area" of the body pretty quickly, although I do think it takes a special person to be able to talk about urine, sex and bowel movements all day.

So, how did I get into myself into this?
I got interested in this type of physical therapy for a couple of reasons. First, because of my grandmother. My grandmother is 90 and has had issues with fecal and urinary incontinence for years. (She probably wouldn't be super happy about me telling this to the world wide web, but she doesn't know how to use a computer, so what she doesn't know won't hurt her.) She has at times felt chained to her toilet, with no confidence that she can go out and do the activities that she wants without having an embarrassing accident. She actually missed my graduation from PT school because she didn't feel she could be that far from a bathroom for so long. I wanted to be able to help people suffering like this. To have to miss out on huge life events of those you love is unacceptable when there is treatment available! By becoming a pelvic PT, I am one more person who is available to help those suffering with urinary and bowel issues. Despite the growing demand, there are not that many of us out there.

The second reason is more personal. I have endometriosis and had suffered with the debilitating pain associated with this condition for several years. When I was diagnosed, I was told that my options were surgery or hormonal treatment, neither of which was a good solution for me. So in the process of trying to figure out what I could do for myself, I found pelvic physical therapy. This has truly made a difference in my life and I wanted to be able to help others who were going through the frustrating situation that I had been through. So many people suffer with pelvic pain for years before they are directed to a physical therapist who can help treat many of the issues contributing to their pain.

When I first started treating pelvic floor dysfunction, I wondered if it would be as rewarding as my previous job treating neurological conditions, such as stroke and spinal cord injury. The answer is that I think it is more rewarding. I am able to help people overcome private issues that negatively impact their lives on a daily basis and I am treating an underserved population. Just looking at the Austin area, a search on the American Physical Therapy Association website for those specializing in pelvic floor dysfunction brings up 10 therapists. The number of general physical therapists was 75. Granted this is not entirely representative of the PT population, as Austin tends to be a hub for pelvic PT. Sullivan Physical Therapy, where I work, has 7 pelvic therapists and we are one of the largest pelvic specialty clinics in the United States. So if 10 to 75 is the ratio in Austin you can imagine how low those numbers are in other areas. Unfortunately, this causes many people throughout the US to be unaware that there is help out there for their issues. This is why I do this blog. I want to reach as many people as possible and educate everyone I can so that people know all their options and don't have to suffer needlessly.

Thursday, January 23, 2014

Sullivan Physical Therapy - A Voice for Education

So excited to be getting the word out about pelvic floor physical therapy! Sullivan Physical Therapy was featured in the December edition of Texas MD. Click on the link below and go to page 26 for the full article!

Monday, January 20, 2014

2014 Update

After a brief hiatus over the holidays, "What's Up Down There?" is back! In 2014 I will be working hard to get as much info as possible out about pelvic floor physical therapy. I will be adding information more often, so check in weekly to find out what's new! For today, I'll leave you with a little humor for this Monday morning.
Courtesy Camilla & Rose Greeting Cards

Wednesday, November 27, 2013

More Pelvic Physical Therapy in the Media!

In the spirit of Thanksgiving, I wanted to share something I am thankful for. I am so thankful and happy to see more and more stories about pelvic floor physical therapy in the media! I am thankful that the word is spreading that there is help available to those who are dealing with pelvic pain, urinary and bowel issues. This is a group of people who have been suffering needlessly for far too long and I am so excited to see information coming out in mainstream publications and television.

Recently The Huffington Post published a story in their Healthy Living section titled My Privates Have a Personal Trainer: Stories From Pelvic Floor Rehab. The author, Lynn Shattuck, is a woman going through rehab for some urinary issues. I think it is so wonderful that she is shedding a light on pelvic floor PT! She walks you through her appointments with a humorous view on her situation and gives you a peek into what its like to work with a pelvic floor therapist.

As much as I can tell you as a PT who does this type of therapy, and as much as I can talk you through what's going to happen, reading it from someone who is actually experiencing it is going to give to you good picture of what it will be like for you and probably help answer many questions that you may have.

The article has turned into a series, so go give it a read!

My Privates Have a Personal Trainer: Part 1
My Privates Have a Personal Trainer: Part 2

The Doctors also featured an episode on pelvic floor dysfunction last week. In the second clip they talk about pelvic floor PT:

It is so exciting for this information to be put out there. Here at my clinic we do our best to educate doctors and the public about what we do, but to see this all coming out on a national stage is really amazing. So to further spread the word, please share this information with your friends and family, I would be so thankful if you did!