You Got This

Inspiring new treatment room at Mary Greeley helps women facing deeply personal issues related to pelvic pain, incontinence.

By Susan Flansburg

Cindy was with a group of long-time friends who had gathered to celebrate a birthday. It had all the makings of a great night. Soon the women were laughing so hard, tears began to stream down their faces.

The fun ended abruptly for Cindy, though, when she wet her pants. She left immediately.
Statistics show that as many as one out of every two women know exactly how Cindy felt that night, because they have suffered from the same condition of urinary incontinence. It’s more than just embarrassing or even inconvenient. It can rule and ruin everything.

Incontinence is just one symptom  of pelvic floor dysfunction, or PFD. Cindy, like many other women coping with these symptoms, turned to Mary Greeley Wellness & Rehab physical therapist Katie Albrecht, MPT, PT,  and a new Women’s Treatment Room for help.

Life-altering Symptoms

PFD refers to any problem affecting the system of muscles, nerves, and tissues supporting the organs of the pelvis,  including the bladder, bowel, uterus, and vagina. This can cause problems with urination (having to go urgently/frequently or leaking urine), and/or bowel function (constipation/difficulty going or leaking stool). It can also contribute to pain or pressure in the area of the vagina and lower abdomen. For some women, sexual intercourse is painful.

Causes are hard to determine. Risk factors may include obesity, genetic predisposition, and trauma.

Albrecht has 16 years of experience treating PFD, and she published a PFD evaluation and treatment guide for physicians in the Clinical Obstetrics and Gynecology medical journal.

“A patient with PFD needs input from their primary care physician, physical therapist, and other consulting specialists, and often a psychologist,” said Albrecht. “Physical therapy is a first-line treatment for many women. I work with many women who have incontinence issues, as well as problems related to pelvic pain and sexual pain.

“These are all sensitive issues and often interconnected. Pelvic pain and sexual pain can be particularly challenging for a woman because they impact them personally, as well as their partners.”

Be Prepared

PFD erodes quality of life, self-confidence, and identity. Cindy’s a  good example. She used to think of herself as independent, spontaneous, and joyful. So much has changed.

There’s no such thing as spontaneity in Cindy’s life anymore. Wherever she goes — whether to work or shopping — she often carries an extra set of clothes. And that’s just the beginning. 

“I have to think ahead,” she said. “I drink less liquid before I go anywhere. The first thing I do is look for the bathroom. I need to plan when and how to get to one in time.”

Once a world traveler, Cindy said her condition has “definitely stopped” her from doing what she wants to do.

“I live four hours from my hometown and I can tell you where every bathroom is along the way,” she said. “If I go to a play or concert, I sit at the end of the row so I can leave as fast as possible. People sometimes say, ‘But you just went.’ It’s embarrassing.”

The fact that 50 percent of women share Cindy’s condition might make them more sensitive to the possibility of incontinence, but women who have it tend to suffer in silence.

“It’s a constant source of anxiety,” she said, ticking off questions she must answer wherever she is. “Is the bathroom in working order? Can I get there on time? Do I have all the supplies I need?”

Finally, Cindy broke her own silence and asked her doctor for help. She was referred to physical therapy for treatment. Albrecht gave her the exercises, education, and encouragement she needed to treat her condition. Then, two months ago, Cindy landed in the emergency room.

Pain

“I felt like I had fallen on the bar of a bike,” she said. “I’ve never had that kind of pain. I couldn’t sit. I couldn’t drive. I couldn’t control my bladder again.”

Cindy underwent tests for everything from a blood clot to a urinary tract infection. Finally, she was diagnosed with pudendal neuropathy, another disorder under the PFD
umbrella. It meant that somehow a nerve had become entrapped, creating constant and nearly unmanageable pain.

Cindy was given medication and a special cushion to relieve the pressure she felt when sitting. When she returned to her physical therapist, she was near tears. Albrecht welcomed her patient back with open arms.

“Katie is so calm and caring,” Cindy said. “She helps normalize the situation. She encourages me that down the road I will feel better, but I have to take it one day at a time.”

“There’s an emotional component to all pain, but when a condition also affects your self worth, it’s so much worse,” she said. “You think, ‘Am I going to have to wear diapers?’ ‘Can
I leave the house?’ ‘No one will want to be with me. I’ll never be able to have a child.’ These are enormous weights to carry around. It would be unusual to not be emotional.”

Such fears often compound a patient’s physical pain, creating a loop of grief and hopelessness. Cindy can relate. So Mary Greeley’s new Women’s Treatment Room is not only a place to meet with Albrecht, it’s part of the treatment itself. Cindy calls it the  “extra touch” she needs.

“It’s so calming and private,” she said. “It’s got soft lighting. It’s wonderful. It’s not clinical at all.”

Cindy said she can relax and share her concerns honestly while focusing on what she’s learning.

“At least half of what I do is educate,” Albrecht said. “The new room is a much larger and more inviting place to be than the room we used to use. We can pull up chairs and have a good conversation. There’s room for family members or partners too.”

There’s also what Albrecht calls her “virtual support group,” a message board on which patients can write words of encouragement to other patients.

“Patients have walked into the room and burst into tears as they look at it,” Albrecht said. “These women are isolated, alone, embarrassed. So when they see someone else with the same diagnosis writing to them, it’s very impactful.”

Cindy said it’s the first thing she looks at when she goes to her twice-weekly appointments.
“I love the message board,” she said. “It gets me through. I sometimes think, ‘I can’t do this.’ But then I see, ‘You got this.’ It’s real patients writing to other patients like me.”

Not Alone

Cindy’s treatment will take time but, as the message said, she will get through it. The pain is now manageable and the cause will eventually—with Albrecht’s help—abate.

“I know it will take time to heal,” Cindy said. “It didn’t happen overnight. I have no idea what caused it. I did fall at one point; maybe that did it. But Katie encourages me to have patience and go slow. I know I’m on the right track.”

Albrecht loves hearing that. Cindy “is a very special person to me,” she said. “She’s had quite a go with this. She’s making great progress.”

What would she say to all the women who are suffering from PFD but not seeking help?

“First, know you aren’t alone,” Albrecht said. “One in five women have pelvic pain, which can affect you during sexual intercourse, or even when you sit down. How do you go
to lunch if you can’t sit down? It’s hard to explain that you can’t sit because your bottom’s on fire.

“Second, urinary incontinence is no laughing matter. Even though we say things like, ‘Don’t make me laugh because I’ll pee my pants,’ it’s real and disturbing.

“Third, most people don’t know anything about PFD. It’s hard for everyone to talk about.

“Finally, there are people here to help you. Do talk to your doctor. Ask to see a physical therapist. You can get better.”

Do you have concerns?

Women with pelvic health concerns can contact Katie Albrecht at Mary Greeley’s Rehab & Wellness department, 515-239-6770.