What physical therapy is done???

[tbokay]

I am being referred to physical therapy for possible PFD. What can I expect when I go? Cuz from what I found online ... I don't want to do it!!!

I am very modest. I don't like the idea of someone or something being inserted into anything!!! I hate it and climb the walls when they have to insert catheter ... what will it be like when I have to lay there while someone inserts something into the vagina?!?!?!?! Even for yearly physicals, I dread them as they are painful too.

I was molested by two different people when I was younger ... so I very protective of my body. (yes I have gotten counseling for the abuse).

If anyone can please tell me what to expect for "physical therapy" please tell me! Does it help? Does it make bladder and urethra muscles relax enough? Is this something they can just tell me to do and I can do at home (although I probably wont!)

[tigger_gal]

When you go in and see if you have pfd they do a tet on you (at a lose of the name right now) You yourself will insert small white plastic device, it look much like a tampon, into your vagina... there is a long lead on it that will get hooked up to the machine. It is painless, they will have you do several different thinks to determine the serverity of the pfd if at all.. My test showed I have no muscel control..
I posted these before and weant and dug up my long lost post lol, so you will have an idea on the exercises. Brat.

Pelvic Floor
Strengthening & Stretching Exercise

1) Lower trunk Rotation
lay on your back with knees bent. Slowly roll your knees from side to side.
Be sure to roll segmently, first hips, then pelvis, lower back then upper
back. Keep shoulders on floor. hold for 10 seconds.

2) Kegles (not IC friendly)
thighten your buttocks and pelvic floor muscles. Practice by cutting off the urine
stream while urinating (again, not IC Friendly) Don't hold your breath. Do it laying or
sitting. Do 5 quick in a row. build up to you can hold each one 10 to 30 seconds.

3) Ball Squeeze
Lay on your back with your knees bent. Feet abt 10 inches apart. Place an 8inch
play ball between yout thieghs and squeeze holding 5 to 10 seconds.

4) Kness apart with theraband
lay on your back with knees bent and feet togeather. Wrap stretchy theraband around both legs, just above the knees. Move knees apart about 10 inches and hold apart
for 5 to 10 seconds.

5) Pelvic tilt.
lay on your back with knees bent. Tighten stomach muscles and lift tale bone
off floor, keeping your lower back on the floor. hold 5 to 10 seconds..

6) Bridging
lay on your back with kness bent. Lift buttocks off floor. hold 10 seconds.
Advanced do keagle after you lifted butt up (not ic friendly)

7) Double knee to chest
lay on your back with knees bent. Grab both knees and bring to chest.
hold fot 10 seconds

8) Double leg lift.
lay on back with knees bent. Lift legs up 2 inches off mat and hold for 10 seconds

9) Hamstring stretch
lay on back, legs out stretched, Bring one leg straight up towards the ceiling. Grab
leg with both hands and hold for 30 seconds. keeping knee straight.

10) Piriformia Stretch
lay on back with knees bent. Cross knee over the other knee. Use hands to pull the knee towards the opposite shoulder. hold for 30 seconds.. then switch and do other side.

[tbokay]

Thanks for the information ... but still not liking it.

I don't wear tampons as they hurt. When the gyn does their check I am always trying to climb the walls when they insert the spectrum!
To have a catheter inserted in the urethra always feels like I am being torn inside.
And to stick anything in my rectum is a major no! I hate it when the gyn does it for physical.

I guess if I want to feel better I will have to do the physical therapy ... but maybe someone can knock me out first?

I don't know how to tell my boss I have to have physical therapy -- I am hoping they have evening hours so I can go after work and not have to tell my boss at all. They just don't understand - all they know is that I have tests done and take meds but no clear answer to the abdominal pains, periodic urine retention and take time off work for more doctor visits.

[SrMaggie]

Tara, I can understand your feelings. I asked my Nurse Practioner, if the next time she does a pelvic exam, that she would let me put the speculum in, and then she could do her thing. She laughed.
I have had the experience of not wanting some of the things done that need to be, so that I can feel better. It really is hard to get the strength to do it.
It took me several weeks to get up enough nerve to do a self-cath to instill heparin/lidocaine and sodium bicarb. I found myself not wanting to do it. But it felt much better having done it. I even would like to try another round of it. I was proud of myself that I could do it. I usually hate anything to do with medicine. But when it comes down to it, I try to rise to the occasion.
I understand your reluctance to let anyone do anything in the pelvic area. It makes me feel so out of control of the situation. You can't see what they're doing and it hurts. When they say take a deep breath, it does nothing to ease the discomfort. Know that you got somebody pulling for you. Prayers.

[Melanie]

First, find a really good therapist and before any exam... sit down and tell her your history and your hesitations.

I don't have a problem w/ the modesty. It can be uncomfortable at times. I got once per week and many sessions are more like deep massages. We don't always do the pelvic internal myofascial release. It's possible that you can benefit from external work (legs, buttcheeks, lower back, abdominal work) and may not need to have the internal work done.

However this could be a very healing experience for you, physical and emotional. But you've gotta form a trusting relationship w/ the therapist first, especially considering your history.

[Franny]

tbokay...tell them to use a pediatric catheter and to use an analgesic before inserting the catheter. Be sure to WAIT five minutes while the analgesic takes affect before inserting the catheter. This should help with catheter discomfort.

[tbokay]

They tried to use lanocaine once to help numb the urethra before putting in the catheter ... I burned so bad I was crying - even after they removed the catheter (which was attached to a leg bag), I burned in the bladder and urethra for a few days. I won't do that again! I would rather deal with the urethral spasms after being cathed than that burn.
Thanks for the advice though.

[creatingkarma]

I'm in the same boat you are. I'm looking at physical therapy too & am scared to death. It has taken me 3 months just to call & make the appointment.

[massagedoula]

I LOVED physical therapy. I am sad that it is over now but I did my 20 treatments. I will go back next year if I still need it. It is great. Don't be scared.

[MakinIT]

tbokay: is it possible you are allergic to latex? it may be possible, if that catheder was not a latex cath...(and why it hurt so much, flared you, sent you into that vicous circle of Pelvic floor pain....bladder pain....more pelvice floor pain....more bladder...you get it....seriously...your desription of what it feels like to have a cath put in sounds like a latex reaction.

As for PFD...I ain't crazy about it. This is my second round. (cause I stopped my exercises, and got myself into a hole emotionally....I'm forced to start over) however..your PT shouldn't be using a speculum. only her finger, which should gloved, in a nitrile glove with lots of lubircation. Then she will feel for tender points in your pelvic floor. If you were a man, she'd have to do it rectally....yuck. Generally it hurts like a bugger in towards your bladder..she will relax those spasms. If you've had a hysto, you'll find that you are very sore at your "vaginal cuff". If you've had any surgeries, your IC is really hurting possibly by adhesions. those can be loosened by PT...I also get the feelingmore will placed in your vagina. Not the case. The will do bioeedback, if you allow it, but the leads are placed on your perineum. Then you watch a graph and follow the commands of the PT as far as what to do to make the graph do differrent things. then you can feel the different muscles working, the way they need to after you finish PT, so you can finish strengthening them.

Best of luck...I know your past makes this so much more difficult and I can't pretend to walk in your shoes. You need to be open with the therapist. She will really understand. Most therapist, especially therapists who work with women, have been trained...and beyond that, are so empathetic in those issues. You need to listen to what your body needs.

Are you seeing a pain therapist? If so, maybe he/she can help you with this. I was so scaredto have aprocedure done last year and my psych does hypno. He taught me to relax through this, sort of re- programmed my brain. What is weird is I really didn't understand how much his sessions have worked with me until tonight. He has been doing some sessions to teach me to sort of go "out of body" if you will (it sounds wierd) when pain really hits...I dozed off and went into deep sleep. during my sleep, my pain meds wore off and I actually started going into an Out of Body thing. I kept leaving my body and trying to go into my daughters room, then into the ceiling. When I actually finally woke up I realized I was in some major pain. For my procedure last year, it kept me relaxed, b/c I had to be awake. Anyway, think about it, and the latex thing

[PikkuMyy]

My PFD is currently in remission (WOOHOO!) since September thanks to PT.

My PT was wonderful. Here's what she did:

1) internal massage through vagina or rectum - she prefers rectum as she can reach more muscles that way
2) external massage of pelvic muscles on abdomen, hips, upper buttocks, etc.
3) taught me how to do physical exercises like leg and abdomen stretches
4) taught me how to to the internal massages using an acrylic dildo that's curved so that you can easily massage the trigger points yourself (It's called the Crystal Wand and I recommend it highly for getting rid of those sore spots.)

I went for about 7 sessions and did the massages and stretches in between.

The first session's massage was agonizing. When she found my worst trigger spots, it felt like I was having the worst flare of my lifetime. But when she finished, I relaxed with a really hot heating pad for about 15 minutes and shortly after, it didn't hurt any more. Each session's massages got increasingly easy until I didn't mind them at all. I noticed a HUGE difference in my pain response to the trigger points with each session.

At this point, I try to remember the stretches once a week or so (more if I'm tense, etc.) and same with the internal massages.

I know it's scary but the reason you can't stand the checkup and pelvic exams is because your trigger points are so tense that even light touches hurt. While I wasn't as bad as you, I certainly had that going on. (Minus the abuse-related anxiety.) But since the PT, it doesn't bother me any more. I can have sex with many more positions than I used to without feeling like I have to pee or pain in my bladder. And my hips and thighs are way more relaxed and stretched than they used to be (I used to get cramps and pain if I sat in certain positions for very long.)

Please try to go and do as much as you can! It may be best for your sessions to be short to start with.

[MakinIT]

And keep in mind, while pikkumyu was very open to trying some techniques that many would find a bit disconcerting, a therapist would not force you to do any that you feel uncomfortable with. However, the warm blankie on your bladder after is very nice,,,,when I had it done, It was heavy, a little moist and very warm. I zonked. That, i figured, was the carrot they were holding for me, And it is very importand to do the stretches, all the way into your upper thigh where it joins hips.

Traceh

[tbokay]

There is absolutely NO WAY anyone is going to put ANYTHING in my rectum!! The ER doc did some test where he inserted his finger to check on spinal nerve as cause for the retention - even though he was in there maybe 2 seconds IT HURT!! That is a definite NO! That is an EXIT ONLY area! Alarm will sound if inserted - meaning I will scream again. No two-way about that one.

My lower back usually hurts so a massage may be nice. And to do leg and ab exercises may help .. but the dildo is also a definite NO!

My cat is my heating pad. She knows when I don't feel good (sometimes before I realize it) and she will lay on top of my bladder. While most times it hurts, having her lay on top sometimes eases the pain.

I am not going to worry about it now .. its still 2 weeks away. I will see and listen to what the therapist recommends - but ultimately it is my decision on what I will and will not have inserted anywhere.

I'll keep you posted on how therapy goes.
Thanks.

[MakinIT]

tbokay: I wholeheartedly agree and you don't have to do that, as Istated. Don't worry, they won't do anything you won't feel comfortable with. But the treatment is great. (I also never used a wand doohicky, although I can see it's value to hit the trigger points.) You'll find out when you start you have those. They may suggest biofeedback..in that case, it's a little pad placed near your anus, another near your vagina, and you watch a computer screen and follow the therapist's instructions on what to do to make you muscles work.

Gotta go

T

[sacausa]

My urologist has wanted me to go for PT for quite a while now. I have always been firm in my refusal. I am only 17 and not sexually active (never been either), and the idea of PT is very disconcerting to me. Having read some of the peoples' posts in this thread I am very happy that I have refused PT and I think I will continue in my refusal regardless of what my urologist (who isn't even sure I have PFD) suggests.