MY FIRST PT

[Lara]

Hi all,
Next week on thusday i have my first PT,i am scared to death about it,after reading posts ,were PT brought more,terrible flare ups!
I have'nt been diagnoes with PN/PNE (yet) ,but pelvic muscles spasms,levator ani syndrome .
What are your recomendations to me? since my pain is not that bad,but noticeable and annoying,today i have a "feeling" in my rectum ,with some perineal discomfort.since i started using the valium,the symptoms have decreased.
what shold i tell or ask to the physical therapist ?
how is the therapy done? vaginally? rectally? what do i expect?
i remember once my colo rectal dr did a rectal massage and that made my terrible worse!
any input would be so much appreciated,

thanks

Lara.

P.S JANETM2 WHERE ARE YOU??!!!

[Faith]

If it is a pelvic floor PT they will do internal vaginal and maybe rectal massage (if you are ok with that ). They should also look at your pelvic alignment for sacroiliac joint dysfunction if they know anything about manual therapy. They may also check for myofascial restrictions exteriorly around the inner thighs, hamstrings, glutes etc.

I am one who got extremely worse from PT. I think my experience is unique but I went to PT postpartum 6 months after the birth of my daughter with intercourse pain and feeling like things were"falling" down when trying to run/ exercise. I left after internal massage and SI joint manipulation with extreme pelvic floor burning and the inability to sit. I do not want to scare you but I do want you to be more aware than I was. I had no idea what PN was and even though I am a nurse, I was not educated enough to know that the therapy I was receiving was too aggressive.

Just remember that you are in control of your PT sessions not the PT. If what they are doing hurts don't let them do it. If you continually leave each session in more pain than when you went (like I did) then stop going. The treatment may flare you up for 24 hours but if it last more than that it's probably too aggressive.

I did later find a PT who was less aggressive but I still did not receive long term relief from it. Give yourself a time limit. If after so many sessions i.e. 12 you haven't seen any improvement I would suggest stopping and either finding a more experienced PT in PN or a PN specialist. PT will drain your bank account and often PTs will tell you to keep coming that they can help you when they cannot. PT will not cure PNE so after so long with no improvement you may need to start to explore other treatment options.

I hope they you have a great experience with PT and that this greatly reduces your pain.

[nyt]

The first time I tried pelvic floor PT was a disaster. The physical therapist had only been doing pelvic floor PT for about 1 year and had never had a patient with PNE before. She was use to working with patients that had pelvic floor muscles that needed strengthening and not someone like me who had hypercontracted pelvic floor muscles. Unfortunately, every visit I would tell her she was making me worse and worse and worse but she didn't listen. I finally quit going and my urologist told me to quit going.

However, this time around I did alot of asking around of my woman friends. I have been seeing a pelvic floor PT since about 10 weeks post-op from my right pudendal surgery with Dr. Hibner. She has been a PT for about 30 years and almost 20 of it as a pelvic floor PT. She listens to me and is extremely gentle. We work closely together for what I can tolerate for at home work on myself and what she can do when I'm there. A few times my legs were quite bad when I got there so she only worked internally for about 3 minutes the rest was very gentle work on my butt and hamstrings. The key is to communicate with the PT if something they are doing is to aggressive and makes you worse. Most PT's will tell you that you might flare for 2 days or so but my new PT tells me if I flare more than 1-2 hours than we were too aggressive. I do better with interal rectal work as I don't flare to bad with that. The internal vaginal work we have to be extremely careful because I have absolutely no sensation on the right side and can't give her any feedback if the pressure is too much because I can't even tell that she is touching on the right side. However, if she is too aggressive by the time I get home my right adductors in my leg will be spasming and very painful.

I guess the take home message is communicating with your PT what is working and what is making you worse. If they are too aggressive and you will know that then find someone else who can work with y ou. This has to be a team.

[janetm2]

I was one of the luckier people most of the PT did not flare me. Right after they found the two tight ligaments and that was PNE of the pudendal nerve i had a painful session and soon after PT said we should stop and it was time to see Dr Marvel. Since surgery just one weird imstance that did not last much past leaving the office maybe subsiding took 1/2 and then i did ice and was fine. The PT I see does alternate what they do so I get breaks every other session for rectal. A pain rehab group tried to say I should have daily PT and the PT group I see was dead set against that since it is not appropriate. Best of luck and let us know how it goes.
Janet

[Lara]

Thank you all for your responses,i will do my best on thursday.
A year ago i was preparing with my family for a month trip to my country ,and this year since the very beginning ,on feb i was very ,very,very sick,
went to the hospital and guess what? i was positive with MALARIA,yes ,i was the only one,chosen by this mosquitoe ,we were a gropu of 15 in that amazing trip,
but i overcame the malaria and in two months was brand new,or that is what i tought.but reacted very well with the toxic medications for malaria.In march my dad was hospitalized,in may my mom had a car accident.both of them are ok now.
And in july boom! my rectal pain started,Am i cursed? or what?
keep me in your prayers ,please ,i feel that i can't tolerate more pain ,physically and emotionally i feel terrible.

Lara

[nyt]

Oh, Lara, my heart goes out to you for the year that you have had!! Prayers and a BIG hug sent to you.

[Lara]

Hi ,
Oh well,i had three pt sessions already,not big flare ups,but i am having some pain.
My physical therapist found out that my hips are misaligned,the left one ,and also very tight muscles in left side of the pelvis,she told me this
past wednesday that i might have PN/PNE ,because she said that my muscles were more relaxed when she touched them,and if that was my problem(muscular) i should be feeling better.
Made me feel so sad,since on the first visit she tought my problem were muscular ,but now with the pts and muscles there being more loose ,and still in pain,she thinks is PN/PNE.
My left leg hurts,as well as the hip,so now she is treating me,hip misaligment,muscular disfunction(left side only),and nerve.SO SAD.
Next pt ,on tuesday and thursday,I always try to be positive but this is getting me very depressed.

Lara.