Just told I have pfd

[redizhere]

and I have had over a year of terrilbe burning in the uretha I seen a new uro gyno ladie today she actually listened...no inflammation in uretha or blockage but said the mucules around there were tight and very inflammed hince the burning and is sending me to pt soon...so how does this stop the burning I ask??? no pills I do still have IC although most of my pain has been in the uretha and still to do the at home instillations of heparin. let me know what I am in for and give me some hope please!!! she also said this may be due to trama from my vaginal hysterectomy less then a year ago thanks xoxo Red in WA state

[kelly McC]

I also had PFD, Vulvodynia and IC I did got to PT for awhile.
I would flare after most of visits but it got better each time I went. I eventually got a tens unit prescribed by PT. It helped me.
Good luck,
Kelly

[poetgirl]

I think Brat posted some PFD exercises that may help relieve some of your symptoms over time. I know of remedies to help urethral burning from inflammation and vulvodynia, but don't know if they'd work for the pelvic floor. However, if you can tolerate it, I would recommend trying calcium citrate and magnesium, because they are both natural muscle relaxants. The calcium citrate in particular has helped a lot with the urethral burning and pain I had.

[Katrina]

I am sorry you also have PFD. I got some physical therapy too...but since my therapist treated me for many things other than the excericises and stretches I am not sure how much of my therpay was just PFD. Anyway...here are some ideas:
practice relaxing the pelvic musscles. When you go to the bathroom and go...wait and relax and message your urethra with a tishue or something.
Use a topical analgesic, alternate heat and cold,
Lavender Oil (the sent is a great for relaxing but to rub on bladder can also have a calming effect. Good for spasms)
• Moisture (Moisture helps relax your pelvis is calming to your bladder)
Warm Baths (NOT HOT!!!!) No bubble bath or strong soaps, please! Soft soaps, perfumed soaps, bath salts & bubble baths can be very irritating to an IC patient. However, you can put baking soda in the tub for extra comfort. SITZ Baths Definition: A sitz bath (also called a hip bath) is a type of bath in which only the hips and buttocks are soaked in water or saline solution. Its name comes from the German verb "sitzen," meaning "to sit." I recommend: (a tub divided into two …one half is filled with hot water and the other cold. With part of the body on one side and than switching and back again in quick succession) Recommended 3 times a day for 20 min each
Warm wash cloth

My way of answering your question about the burning is that it caused by tightness and musscles not really able to handle all that they have to do...the therapy helps to relax them and strengthen them.

Hysterectomies don't help the pelvic floor that is for sure!

I suspect that your therapist with use a little machine to prove how well you can relax your pelvic musscles...she may have you take it home and practice...she/he will probably give you excersizes to do. Usually they are a tightening and relaxing of the musscles. I had to do a circle kind of tight relax thing where I would tighten and than relax the different musscles in my abdomen. I would have to go both directions and than jump around. I think physical therapy in the run has helped a lot of us so do have hope!!! Be warned that not all physical therapy is good for IC.... be the boss of your treatment!

So often, IC patients become discouraged after trying to exercise, therefore, it's best for patients to use a conservative approach. Performing too many repetitions of a movement, or holding a stretch or a posture for too long can be detrimental. Muscles may not be able to find a resting place after over using them.
Most IC patients should also limit exercise routines to 20, or 30 minutes maximum. Patients should always practice new routines slowly and cautiously. Five minutes of gentle exercise (that does not hurt you) is better than no exercise at all. Exercise and dance videos are available through www.CollageVideo.com.

In my experience, Kegel exercises are not the first line approach to treat the pelvic floor dysfunction of IC. Skeletal muscle has an optimal length for optimal function. If you have a muscle that is too long (overstretched) it will be weak. If you just pushed out a 12 lb baby, your pelvic floor is mostly likely overstretched and weak. Biofeedback is extremely beneficial in that situation to help you locate the muscle and monitor the progress as it strengthens with each active contraction.

Skeletal muscle can also become to short. A muscle that is too short is said to be in a state of contracture. It has the ability to contract, but it will be a weakened contraction with a decrese in its range of motion. A muscle that is too short needs to be lengthened before it can be strengthened. A common example of muscle contracture that most can relate too would be an extremity that has been in a cas. If the arm is broken and in a cast with the elbow fully bent with the hand at the shoulder, when the cast is removed the elbow will be stuck in a fully bent position. Now the biceps muscle is weak because it has not been used for 8 weeks, but it is also too short; a contracture. The biceps would need to be lengthened before it is strengthened. Spasming would not be occurring in the biceps


icnmgrjill> So, what should a patient expect if they come to a physical therapist?

<rhondak>My evaluation involves two components: a pelvic exam and a comprehensive musculoskeletal evaluation. The pelvic exam has two components; and internal exam and a computerized muscle assessment .The pelvic exam is focused on assessing the musculature and other pelvic tissues not the organs. The pelvic floor, also know as the levator ani, is evaluated with regards to its function. Can the patient locate the muscle and perform an isolated contraction? Or does she use other muscle groups to assist her in contracting the muscle? This is also known as substitution.. Is there difference from the right side to the left? Are there trigger points in the muscles? Trigger points can be a source of pain as well as cause the muscle to not function properly. The therapist will also assess the ability of the pelvic floor to relax after a contraction. The ability of the patient to do a lengthening contraction from the resting position is also evaluated. This is also known as an eccentric contraction. An eccentric contraction is the motion that is required to initiate urination. During the internal exam the therapist will also be assessing the other tissues found within the pelvis; the connective tissue and the neural tissue specifically.

<rhondak> We're looking for differences from left to right. It's a two- bellied muscle that has two separate nerves that innervate it. So, we often see that it can become very uncoordinated, especially if there has been trauma to one side. For example, if you came sliding down on the ice and hit your right butt, you could really traumatize that side and the right pelvic floor could be more traumatized than the left. This includes the development of trigger points and neural trauma. The key thing is that you're left with an assymetrical pelvic floor, that can severely limit its ability to function normally.

<rhondak> There are also other muscles inside the pelvis that are actually leg muscles. These are closely related to the pelvic floor muscle. So, if you traumatize a leg, you could set up a domino effect that could cause a pelvic floor problem. You need to monitor those muscles as well. Most physicians (urologists, urogynes, gynees) don't even bother to check that group because it is a "leg" muscle and not thought ot be part of their medical speciality.

<rhondak> One other things that we look for is scar tissue. Have you had a baby? Did you had an episiotomy with the delivery? Scar tissue from an episiotomy or a tear can cause problems. They can in and of themselves be sources of pain but they can also cause the pelvic floor to not function correctly. I had one young woman who had never had a child. But at the age of 12 fell on a picket on a fence. While she was being sutured up in the emergency room she recalls the doctors telling her that it was the same type of surgery that they do during the delivery of a baby. Shortly after becoming sexually active, she developed severe frequency and urgency. When she started physical therapy she was urinating every 15 minutes. During the internal exam the scar tissue from that injury was felt and, was again questioned about ever having had a baby. It was not until then that she even remembered the injury. Intercourse had always been painful and she assumed that that was normal and had nothing to do with the scar tissue. Treatment focused on releasing the scar tissue, resolving the trigger points that had developed in response to the poor functioning of the pelvic floor and behavioral modification techniques to desensitize the bladder. When she finished therapy she had no nocturia and was voiding every 3 - 4 hours during the day.

<rhondak> Besides the internal exam, there is also computer assessment. The computer assessment measures the force the pelvic floor muscle generates when it contracts and its range of motion. I utilize the computer to provide objective data to describe the pelvic floor changes as treatment progress. As treatment makes changes, and symptoms are decreasing , repeating the computer assessment provides objective documentation of the improvement in the pelvic floor function.

<icnmgrjill> What else can cause trauma to the pelvic floor?

<rhondak> Well, we've already mentioned pregnancy and delivery. Other things would include falls, motor vehicle accidents, bicycle riding, weight lifting, horseback riding, etc. And, of course surgery. That includes surgical procedures in other areas of the body that are known to refer symptoms and problems to the bladder and pelvic floor. Examples would be an abdominal hysterectomy, appendectomy, femoral hernia repair, or any laparoscopic procedure.


http://www.ic-network.com/guestlectures/rhondatranscript.html

All of the quotes I found on the ICN...there is a lot of info.
http://www.ic-network.com/search.html Do a search to be prepared on what therapies may hurt you. MOst of us find physical therapy to be very beneficial but if it is causing too much discomfort don't be afraid to say so! :grouphug:

[redizhere]

Thanks so much katrina that was awesome info I am printing it out((((HUGS))))) I will try some of that..I do have a tens unit but it is not the kind I could put in my vagninal area it has the electrodes would it be helpful to put this over my bladder area? I have noticed for the past year I have to really push with my stomach muscules to pee at all:( thanks for all the other suggestions and info as well you all are wonderful! I don't have Vulvodynia or vesbititis? spelling the dr said I don't have those Thank God just the pfd...now if I go to PT for several times and it doesn't seem to be working should I call my dr? or how long should I give it? and another dumb ? what about sex? is this a major no-no ?? I dont' have pain so much during sex esp if using lubricant but afterwards I have swelling and the dr said cause the mucscules are clinched so tight I am not getting good blood flow..she said to continue with my instillations and I might try doing the elmiron a few times that way too someone else in another post said she did that and it helped ..it is sure tearing up my stomach!! and I am on only 100 mg once a day! thanks for all your help! will this get better? will I get my life back? thanks xoxo Red

[Sarojini]

The others have given you great advice already. I have PFD in addition to IC too, and I went to PT. It involves doing a lot of biofeedback, where they place electrodes on your abomen and crotch area, and ask you to tighten and release your pelvic floor (the muscles you use to urinate). By doing this, you can see a readout on a computer screen, and you will realize when you think you're relaxed down there you may NOT be -- and your therapist can give you some exercises to help you learn to relax. Mine also did some deep tissue heating with ultrasound to relax my muscles, and we did E-stim (electronic stimulation) of other muscles in the area to relax them. It was not bad... it actually helped :) Good luck :grouphug:

[redizhere]

I have a tens unit where did she put the e-stem? thanks for your help! ((((HUGS)))) xoox Red

[Sarojini]

The electrode positions were similar to my TENS positions, although she often focused the E-stim on my back as I was having a lot of lower back pain at the time....

[redizhere]

I wonder could I just put them on my lower pelvic area over the bladder region I am not having back pain? thanks xoxoox Red

[Katrina]

I don't consider sex a major no no if it doesn't seem to bother you. For me PFD did make sex difficult but time has helped that. Theese days with the help of lidocaine sex itself isn't as much of a problem...but like you the after is....using the lidocaine again after sex has helped a lot...as does resting!!! Since physical therapy is a slow process I would ask your doctor on the first visit or so how long she expects it to take before you see a difference. I suspecty it is not the same for everyone...I think I saw some improvement every week but they were small small steps.

I suspect things will improve for you!

[redizhere]

I hope so Katrina and great idea about the numbing stuff after sex and I use the lubrication gel as well I get all swollen vaginally after sex the dr said it is cause the blood flow is restricted down there already:( :loco: this is all nuts I tell ya I sure wish they would find a cure I get so sick thinking about this! xoxo Red