Has anyone been seen by a pelvic health physio?

(23 Posts)
Cocolepew Sat 16-Jun-18 16:32:00

If so what did it involve?
Im due to see one in August while waiting for a gynae appointment due to my mesh surgery not working.

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Greenteandchives Sat 16-Jun-18 16:36:57

Yes I have. I was a bit sceptical but it was actually very helpful. I was referred to see if anything could be done to improve my pelvic floor. She did an internal examination and guided me through proper pelvic floor exercises while she still had her fingers inside to feel whether I was doing it properly. I still needed surgery, but she gave me a lot of helpful advice and information in a way that was very accessible.

Slippery Sat 16-Jun-18 16:47:01

Sorry, had to post... Mis-read the thread title as pelvic health Psychic! Was so intrigued as to what that might be.

As you were.

Cocolepew Sat 16-Jun-18 16:52:08

Sorry to disappoint Slippery grin
Thanks Greentea, I thought it might be something like that.
Tbf a psychic would probably be needed to find my pelvic floor!

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Hauskat Sat 16-Jun-18 17:11:01

I’m seeing one now. She is really lovely and it’s not scary at all, just wonderful to actually have someone take your health seriously. She does an internal exam as mentioned up thread. This isn’t painful. She will guide you through your pelvic floor excercises with her hand in place so she can tell when you are doing it effectively. Mine also asked me to keep a bladder journal for a couple of days. Initially she recommended I get a Elvie which is a little egg shaped device that measures how effective your kegels are but it couldn’t really register my efforts so I have been using one of those gadgets that gives you little electric shocks (but not painful) to stimulate the muscles. I’ve just had another session and my muscle strength is massively improved. Next step is to work on my tummy and glutes apparently and she has given me a few stretches to do too. Another thing I have found really helpful that she has done in some later sessions is to lightly press on points in my vagina where I have tension - just like you might a knot in any other muscle. Amazingly I can stand better and feel lighter and walk taller and more easily afterwards. She is going to teach me how to do it for myself too. I have been so depressed about my body being so damaged but my experience with her has made me feel that I can make a full recovery even though I still have a long way to go. My scars have healed well but she thinks they might be pulling a bit and says she can show me how to stretch them a bit. Honestly all this should be offered as standard for every woman after birth. Good luck with it. I hope you find a similarly warm and understanding environment as I have (if you are in London let me know I can tell you the name of the clinic) and that you see an improvement soon.

Cocolepew Sat 16-Jun-18 17:26:15

Thank you. I have a bladder and bowel prolapse which has pulled my pelvis out of shape, Im hoping going will help that.
I know I will need surgery but the waiting lists are shocking so hopefully this will help in the meantime.

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Verbena87 Wed 20-Jun-18 23:48:42

I’m under a specialist nurse for bladder prolapse (not sure if she is a qualified physio or ‘just’ a specialist but she’s fab). She checked my kegels with fingers as described above, and has lent me an electrical stimulation device (it has a name. Its actual name is not what it is referred to in our house, which is ‘the fanny zapper’) which I’ve been using for about 2 weeks and can already notice some improvement symptom wise, so definitely worth going!

I also do Pilates with a qualified physio (general physio, not pelvic floor specialist) who knows about my prolapse. Been going since 8 weeks post partum so can’t really say whether I’d have been worse without it, but nurse and gynae both seem pretty sure it will have helped as it works pelvic floor alongside the rest of your core.

Cocolepew Fri 22-Jun-18 12:07:34

If I don't get a fanny zapper Im going to be very disappointed .

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kelper Fri 22-Jun-18 12:09:06

I need more people to post threads titled like this, I makes me do my pelvic floor clenches instantly!!

user1499173618 Fri 22-Jun-18 12:10:09

In France all women get post natal pelvic physiotherapy.

Verbena87 Fri 22-Jun-18 12:57:38

I think I got the fanny zapper because

1) I have pelvic nerve damage so my muscle response is quite crap still (though getting slowly better) and I think the electricity can help to promote new nerve growth or ‘wake up’ the nerves.

2) I used to fell run a fair bit (maybe 20 miles a week) before I had a baby, which I used to manage depression and anxiety, and I made it clear to the nurse that I’d like to return to running (not prolapse friendly but benefits to the rest of me probably outweigh the harm), so we’re aiming for as strong and functional as possible.

You could try suggesting you’re wanting to do impact/weight bearing sports as a get-a-zapper strategy?

Failing that, you can buy them, but I’d get some advice from the physio about what might be suitable and how to programme it for your needs.

Good luck with it all. I know how pissed off it can end up making you!

Cocolepew Fri 22-Jun-18 13:05:33

I waited 19 months for a gynae appointment only to be told it was too specialist a problem and I needed a uro gynae.
I'm probably a bit older than some of you. My prolapse is due to having a hysterectomy and my bladder falling into the space left, I think it's calked a vaginal vault prolapse.
Because I had previously had a tvt I need to see the Dr who did that.
<googles fanny zapper>

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PaulHollywoodsSexGut Fri 22-Jun-18 13:13:25

Watching this thread. I went to a woman’s health physio after CS1 - it was okayyyyy but didn’t really give me huge amounts of info and I didn’t feel it was worth the £100 price tag.

I didn’t go after CS2...but I’m away to book an appointment for that and an ultrasound of the whole area as I think the surgeon that carried out my 2nd CS might have been having a bad day and I’ve been left feeling a bit butchered.

WhoKnowsWhereTheW1neGoes Fri 22-Jun-18 13:35:06

Yes, I had a few sessions with an NHS one after my prolapse repair, although I only got referred because I had another, milder prolapse which wasn't repaired and so it was for that one, with a view to preventing it getting any worse. As others have said, tailored exercises, and lots of lifestyle advice about exercising safely, lifting safely etc. I also did a lot of googling myself around the subject

This was about 5 years ago, for most of that time I have been doing pilates with a general physio who is aware of my condition and modifies the exercises accordingly, I now also do a yoga class with a teacher specially trained in women's core and pelvic floor exercise and everything is strong and working properly. I do still avoid running and other high impact exercise to a large extent though.

Verbena87 Fri 22-Jun-18 18:03:13

Cocolepew, in the interests of your zapper-googling I’ve had a look at mine. The device is called a ‘neurotrac continence’ (I’m thanking god for small blessings that I’m not actually incontent, it’s on a special programme set by the nurse rather than one of the presets it comes with. Kegel8 devices are meant to be good as well but cost a bit more and I’m not sure they’re actually different apart from looking less NHS-ish), and I’m using it with a ‘periform +’ vaginal probe. Had to buy that bit and because it’s a medical thing got it VAT free but you need a form from the hospital, so definitely talk to them at your appointment in case they think it might help, as they can maybe give you the VAT form.

I’m also awaiting a pessary fitting for undercarriage underwiring when I start running again. Dunno if they’re suitable if you’ve had a hysterectomy but can let you know whether it’s any good if you like?

Whoknows it’s great to hear you’re strong and functional - still have days where I feel ruined so it’s great to hear successful management (both of repair and prolapse) is possible.

Cocolepew Fri 22-Jun-18 19:29:30

Thanks Verbena, I've had a look.
I am incontinent, it was what made me go back to the GP. The tvt helped stress incontinence but not so much the urge.
I take medication for it but its completely out of my control now. I have no power in my pelvic floor.
Tmi but when I need a poo I have to splint , ie put my fingers up my vagina to push on my bowel. There is a dip where it's prolapsed.

OP’s posts: |
Verbena87 Fri 22-Jun-18 21:12:03

I’m not a TMI sort of person (in case that’s not apparent from my posts), but I am sorry you’re dealing with incontinence and having to splint - just such a pain and miserable too.

I’ve not read up much on rectocele so not sure the zapper would do anything for that, but as I’m getting stronger pelvic floor muscles the bulge my bladder makes in the anterior wall of my vagina seems to be lifting a bit and getting less pronounced, so perhaps it’s worth exploring.

Really hope your appointment is helpful, does sound like you’ve put up with more than enough already!

Sevendown Fri 22-Jun-18 21:19:57

This has got me doing my pelvic floor exercises!

smurfy2015 Sat 30-Jun-18 17:16:43

@Cocolepew I am also incontinent. flowers

Part of my problem is my brain signals aren't working right but I was sent to pelvic physio for pelvic biofeedback. I don't have prolapse thankfully but where people normally get a signal from the bladder to the brain to say need to have a pee, I'm missing that, I try to have preemptive pees or otherwise I get a warm feeling which says its too late and im soaked.

She did an assessment, worked out what probe I needed and showed me while I was attached to the big computer monitoring the probe what was happening as I did pelvic floor exercises. She printed out these readings at the first appointment so she could get the baseline, I saw her every 3 weeks for 5 months and then we called it a day as she said I was outside her remit as while she could tell I was doing the exercises as I was completely in time withholding/releasing and breathing calmly the muscles in pelvic region were actually getting worse after about 10 mins into a 40 minute session and I was struggling my way thru the rest of the session. I didn't realise at the time but I had gone way below my baseline of starting the sessions,

I was waiting on seeing a urologist at the time so that was speeded up. He decided to do an exploratory procedure however cos I'm a high risk I ended up on the waiting list for the big hospital with the ICU as otherwise if something went wrong they would be trying to transfer me.

I was also started on medication which helped for a while, the GP had to stop after it caused severe retention. I was meant to be restarted but it didn't happen at that time. The continence service started giving me pads. After a hospital admission for something else, I was put back on the same medication for this.

4 years on the list and no sign in sign of procedure brought me to last year when I saw a different urologist who changed medication which helped a bit and was increased again about 2 months after and suggested urodynamics, it was done in March and I'm waiting to learn to self-cath and will be seen at clinic again.

Cocolepew Sat 30-Jun-18 19:41:45

Good grief smurfy shock
The gynae dr I saw changed my tablets to patches but I pee'd myself without knowing I needed to go or was actually going , so I stopped them.
I know I need to go but can't hold it or sometimes I pee as I walk. Which is nice hmm.
I also can't empty my bladder the first time going, I can feel it low down in my pelvis and usually manage to empty it 10 or 15 minutes later after walking around.
I'll update after my appointment.

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smurfy2015 Sun 01-Jul-18 09:38:56

Heres all the other bits around that -

I was discharged from gynae consultant last summer who said it wasn't relevant for me, dismissed ongoing pain on a 7/10 that had been going for 11 years by then (now 12 years), was absolutely horrible to me, told me he believed my problems were bowel related or psychological basically anything but gynae.

Given that I have been given an endo diagnosis on 3 separate occasions in the past by Drs who saw what my bleeding was like and the massive clotting and pain I am in, they had said in past possible adhesions.

However, those 3 diagnoses have each been taken back with a "don't know what it is", it's not deemed cancerous be thankful for that have a good day.

I've had 4 cysts burst in 12 years but apparently, I'm ok after antibiotics, the pain in the exact same area is relentless. They won't do a laparoscopy as it's not seen as suitable, I am a high-risk patient in relation to GA due to 6 conditions which limit me a lot (4 are neurological) and gynae literally CBA. I've been passed around like the proverbial hot potato.

The last referrals I saw them he saw me twice, agreed after a lot of persuasion to stop periods altogether as they were becoming more spaced out anyhow as in months apart.

So I was started on GnRH analogue monthly injections and HRT to take me into a chemical menopause as it might be the answer I wanted. I was reviewed 9 months later and reported back that it had helped over 75% but given time I hoped that it would get further into the system and break down whatever is causing pain.

Nope consultant decided to stop it there and then as it was a red herring and distracting from the fact my pain wasn't gynae (so why did the hormones help?), so he stopped the medication and discharged me against my wishes and in both visits to the clinic not once was my BP, pulse taken or anything else to get a baseline.

He referred to a pelvic CT scan from 15 months before as current when I questioned it, (I'm a wheelchair user) and when I asked a lot of questions at the 2nd appointment, he took the back of my wheelchair and wheeled me out into the waiting room down the hallway and left me. The tears were coming hot and heavy,

I think he knew I would try to come back in to get my answers if he went to the corridor. It wasn't a time thing, he had asked how did I find the meds, I said helped over 75% he said not good enough and was stopping and recommended asking to see psychology to deal with my "obsession" or bowel people if needed after that. Grrr. I was in less than 2-3 mins, I know cos an HCA was waiting for me to take me to discharge lounge as I was being discharged from medical wards that same day.

Psychology wise, I have seen psychology a number of times over the years and they agree I am trying to cope as best I can overall with the constant onslaught from all the main conditions.

As I have had severe mental ill health since I was a young teen, I have been referred for psych consults to discuss this as it has been seen as "attention seeking". It's not, My personal experience tells me everything is in doubt when a person has mental ill health.

So in end of April I saw the bowel consultant who has referred for tests which with approx waiting list times takes me up till Sept / Oct time and then clinic appointment to see him again for findings, we already know I have IBS mixed as a sub-condition of my main list, as often have incontinence that way too.

Psychiatrist is going to refer to do a referral for gynae and send to GP, psychology too, GP, as well as pain clinic, say they cant help and have rejected 5/6 referrals as I'm too complex for their team so the GP is coordinating this all to go out of area to fight for the best care for me.

Bowel Drs have enough apparently in their notes to point to adhesions but obviously cant see if I have endo first, I don't have diverticulitis thankfully but as a side effect of one of the neuro conditions I get a temporary version of gastroparesis so add to that wonky signals, periods which are all over the shop I never know if I'm coming or going.

I was in hospital in May and you know when the nurse is doing intake notes and asks about last period and I was like yeah that was October the day the cat spent in the vets and she was like that's 7 months ago, are you pregnant, sadly not. I was like it likes to take a break between and even with the hormones in between, it had been 1.5 years since period before. I was out of hospital 2 days when I had a week-long really heavy period where my original pain was worse than ever hence why I still say its gynae related. (its my body so what would i know)

It's a long slow process. I hope you get sorted asap and done end up going thru all these mills

Cocolepew Sun 01-Jul-18 12:22:45

That's shocking smurfy, I'm so sorry flowers.
I've had endo, prolapses, a uterine ablation, tvt, adenomyosis, pcos and eventually a hysterectomy.
The adenomyosis was diagnosed as a bladder prolapse which I argued that it wasn't. I eventually went private and it was diagnosed almost immediately .
I waited 8 months for the hysterectomy and looked 9 months pregnant by the time I got it.
I did think that would be the last of my problems hmm

OP’s posts: |
Pebblespony Sun 01-Jul-18 12:29:26

I went and found it good but mine was a minor rectocele prolapse. The best bit I found was doing the pelvic floor exercises while she examined me internally. It turns out I was doing them wrong, the message was going to the wrong place (if that makes any sense).

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