Transformation—that is a powerful word. It’s an exciting word, full of discovery and opportunity. When I first felt God giving me that as my theme word for this year, I was focused on all the positive connotations. I desire transformation, or at least what is on the other side of it. You see, when I first heard that word I was thinking about the results of transformation, not the process of transformation. The first inkling that there might be something other than pure positive in the idea of transformation came when I shared with my sister about my word for the year. Without hesitation her response to me was, “that sounds scary.” I hadn’t thought about it until then, but yes, transformation does sound a little scary. And now that I have walked through some of the process I will tell you that it’s a lot more than scary—it is uncomfortable and downright difficult. Continue reading
My interview with pelvic floor physical therapist Dr. Julie Sarton, PT, DPT, WCS, was filled with so much great information, I couldn’t fit it all into one post. Here is part 2!
4. What could someone dealing with painful sex gain from seeing a pelvic floor physical therapist like yourself?
I think that we are just touching the tip of the iceberg in terms of people who suffer from painful sex. It’s an intimate condition, and is underdiagnosed—some studies suggest that as many as 40% of women suffer from painful intercourse! When we look at sexual pain there are multiple potential causes, but the musculoskeletal system is one of them that I think is routinely missed. I would guess maybe less than 10-20% of physicians (OBGYNs) out there, during the time of the annual exam, ask patients about their sexual life and screen for potential pain. If the musculoskeletal system is found as a driver, a pelvic floor physical therapist is critical in helping that patient achieve a pain free state.
We become one of the primary care practitioners that help. I think it’s important to remember that almost any problem, whether it’s pelvic pain or sexual pain, usually requires multi-modal therapies. So we are one piece of it, rarely working in isolation. You need a village—a team. We need to be working hand in hand with a physician that can help with the medical management, a good psychologist or sex therapist that can deal with the psychological elements that come, and some people need a pain management doctor, or a guided imagery therapist (like we’ve recently integrated), acupuncturist, etc. There is a different team for different patients, but I would say that the physical therapist for many patients becomes one of the mainstays.
5. What should a new patient expect at their first physical therapy session?
The first session—the evaluation—is always going to be the longest. It’s always going to start with an extensive time period to go through the patient’s history. So many of the patients have been bounced from doctor to doctor and never truly been heard. So our goal with that first visit is to hear the entire story. We want not only for them to be heard, but we need to pull all those pieces out from the past that have set the stage and connect the dots to come up with why they’re presenting the way they do. The next piece is the anatomy and we thoroughly explain to the patient because it can be scary and intimidating, so we go through the anatomy with a 3-dimensional model, thoroughly explaining—this is where the pelvic floor is, these are where the muscles go, this is the nerve innervation, these are the functions—so the patient is comfortable with the exam.
At that point we exit and the patient will get undressed and underneath a sheet. But we start externally because you can’t look at the pelvic floor in isolation. We start with the patient’s posture, looking at the pelvic alignment, the external muscles, and the tendons and ligaments. Continue reading
Have you recognized the power of your perspective? Do you realize the difference that your outlook on life or your perception of a particular situation can make? I have heard this concept discussed many times, and I have believed it on a general level for most of my life. But, it hasn’t been until more recently that I’ve begun to realize just how powerful our perspective can be.
Let me share a very recent example of my own experience of perspective. I have been feeling very overwhelmed these past few weeks, inundated with life stuff, both good and bad. I feel exhausted, wondering why I always seem to end up in the middle of everything, and just wanting a nice long break. Without even realizing it, I have let negative thoughts take over my mind. And not necessarily the obviously negative self-criticism or ‘doom and gloom’ thoughts, just generally negative. Concerns about a friend’s difficult situation and what specific steps she needs to take to get back on track, if only she could see it. Worries about this year’s goals at work and how big and overwhelming they seem. So many constant thoughts that are unconstructive and discouraging, filling my mind so there is no room left for the positive. No wonder I have been feeling so tired and overwhelmed!
Once I realized what I had been doing, I was able to make a conscious effort to flip those negative thoughts through a positive perspective. Continue reading
I have learned just how important it is to be comfortable with your doctor. I think we all want to have a doctor that we are comfortable with, but we often don’t put it high enough on our requirements list. We focus on their knowledge and experience, maybe the convenience of their office location and whether or not they accept our health insurance. While all of those are important considerations, I believe that being able to connect personally with your doctor is just as important. I’m not saying you need to be best friends or go out for coffee after your appointment. What I am saying is your doctor needs to listen to you, and you need to feel heard when you speak to him or her. Your doctor needs to be able to empathize with you and not discount your feelings or jump to a diagnosis without fully exploring your experiences. Your doctor should never make you feel stupid, ashamed, or uncomfortable in any way.
Being comfortable with your doctor is especially important when dealing with something as personal as sexual pain. I may be worse than most, but I think all of us have some degree of discomfort in discussing intimate topics. We keep them guarded and typically discuss only with those we trust—that is precisely why they are called intimate! Thus you need to feel comfortable to be able to explain all of the details of your pain, including exactly where it hurts and when Continue reading
Navigating the healing process of something as complex as sexual pain can be extremely difficult and often overwhelming. One of my biggest pet peeves when it comes to painful sex is how the number one word of advice you will find online is simply to talk to your doctor. On the surface that seems like perfectly good advice, but what happens when your doctor doesn’t know what to do? Or worse, what happens when your doctor tells you there isn’t anything wrong, implying that it is all in your head? My response, get a second opinion—or third or fourth or fifth, as the case may be. Continue reading
In life and relationships we will often receive advice to temper our expectations of others. We hear things like “give them the benefit of the doubt”, “nobody’s perfect” and “be reasonable.” While that advice is all well and good and often important to keep in mind, there is also a danger to that way of thinking. We run the risk of lowering our expectations too much and settling for a life or a relationship that is not fair to ourselves as individuals. Continue reading
If you are still searching for a correct diagnosis, or waiting for treatments to work their healing effects, I want to encourage you to keep searching and keep working. I know how discouraging it is to go from doctor to doctor trying to find out what is causing painful sex. I went three years, through six different doctors and multiple tests and treatments before finally getting a correct diagnosis of hypertonic pelvic floor muscle dysfunction. Then, after two years of physical therapy I went through a couple more doctors to address the pain issues stemming from unbalanced hormones. During that first searching process I actually did give up at one point. But, the pain kept coming so I had to keep going.
It takes courage to not give up when doctor after doctor tells you they don’t know what is wrong. Draw that courage from wherever you can. Maybe it is from the countless others who have dealt with and overcome similar pain issues.* Or perhaps by connecting with those who have overcome other types of obstacles. Maybe you can draw courage from your spouse and the hope of what can be on the other side of healing. For me, I was able to draw courage from my faith. Knowing that God was with me helped give me courage to keep trying. Continue reading