Some responses to the topic questions may be found below. You may find the complete transcript of this chat here and the analytics here.
T1: What is pelvic health and why is it important?
- Great question because most people don't know what #pelvichealth is. It involves the entire area of the bony pelvis, lower abdomen, genitals, reproductive organs, muscles, bowel/bladder/sexual function, nerves...and more (for male and female parts).
- @bcmhouston website states : "Pelvic Health is best possible functioning & management of the bladder, bowel, and reproductive organs. It is not merely the absence of disease or weakness in these organs."
- Treatment for GYN cancers often create issues with other organs & systems in the pelvis. GYN survivors often have bladder/bowel issues after radiotherapy & surgical treatment
- During #brachytherpay, radiation is applied directly to the cervix. While effective in treating #cervicalcancer, it’s side effects can be devastating to the pelvis and vagina.
- Pelvic cancers impact pelvic health - both disease and the treatment can cause pain and organ dysfunction - both surgery and radiation can effect function of the bowel and bladder
- hysterectomy to treat cancer has complications which need proper care. Hormonal Changes in pelvic structure (improved with pelvic Physio for MSK training which has level 1 evidence Bø et al.)
- The pelvis is a complex space - with bowel, nerves, bladder, blood vessels - cancer or cancer treatment can impact any of the components.
- Many women in our Cervivor community are finding relief from pelvic pain after working with a Pelvic Floor Therapist. However, for those in more rural areas, they may not have this option
- So, we highly recommend seeking out professionals who know about pelvic pain. Such as GYNs, Urogynecologists, Urologists, Pelvic Physical Therapists, OTs, NPs (to name a few) who attend conferences or take courses in pelvic pain care. (Such as @PelvicPainOrg
- Seems like several specialists are involved in overall pelvic health - gynecologist, gastroenterologist, urologist, GI docs and there is even a urogynecologist. Seems like patients would need navigation related to their particular symptoms.
- Here are just some of the things @MayoClinic lists as pelvic pain treatment options: Medication, Physical therapy, Stretching, massage and other relaxation techniques, TENS, Neurostimulation (spinal cord stimulation), injections and psychotherapy. https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/diagnosis-treatment/drc-20354371
- It’s hard to feel sexy with pelvic pain.
- "Asking about sexual pain and dyspareunia and performing a thorough physical examination are essential steps to guide management, which must be tailored to individual patient goals." Yes! Tailor treatment to the needs of patients https://www.ncbi.nlm.nih.gov/pubmed/27607852
- Don’t give up on intimacy. Be patient with yourself. If you have a partner, COMMUNICATE. Communication is KEY to finding what will work for you and your partner.
- #SexualHealth IS #pelvichealth. It's important for those who have partners to continue to have all sorts of emotional and touch intimacy. Not just penetration focus. I see so many cases where this changes.
- From a needs assessment in 2010 "Greater than 40% of survivors expressed interest in receiving sexual healthcare, but few had ever sought such care"
- It was recommended for me to follow excellent work by people like @will2lovedotcom for resources. Check this out at https://www.will2love.com/
- Like all physical therapy, pelvic PT can help break up scar tissue, help regain strength and range of motion and help restore function. https://www.pelvicsanity.com/single-post/2017/06/21/Pelvic-Physical-Therapy-after-Surgery---Why-Pelvic-and-Abdominal-Surgeries-Need-PT-Too
- @PelvicGuru1 website explains what pelvic physical therapy is https://pelvicguru.com/2013/12/28/what-is-pelvic-physical-therapy-and-why-doesnt-everyone-know-about-it/
- Physical therapy is a profession,not an intervention or a technique. What happens in a visit depends on who is the therapist. A pelvic health PT can do a careful (not painful) eval and help set up an individual program
T6: What are some pelvic health resources for those impacted by cancer-related diagnoses? What have you found helpful?
- Love this question because so many people still don't realize that there are physical therapists who specialize & care for pelvic health conditions. Doing this 20 years and my mentors many more. Patients often say "WHY didn't I know this type of care existed before!?"
- You can also find excellent people at @APTAtweets @womens_PT @HermanWallace and ask her on twitter with #pelvicmafia
- Typically, there's a recommendation to wait at least 6-8 weeks after a gyn surgery to do any type of internal/vaginal assessments/treatments for pelvic PT, but there's so much we can do even before that in terms of movement, touch, education, etc.
- In addition to those organizations and practitioners joining along on #gyncsm, many find the @hystersisters site - not a nonprofit btw and does have ads - helpful. https://www.hystersisters.com/vb2/article_757741.htm
Our wishes for the #gyncsm community.:
Dee
Co-moderator
Resources
@GYNCancer Renewing Intimacy & Sexuality after Gynecologic Cancer brochure https://www.foundationforwomenscancer.org/wp-content/uploads/Sexuality-Brochure_Final.pdf
@DanaFarber Sexual Health, Intimacy and Cancer https://www.dana-farber.org/health-library/articles/sexual-health,-intimacy,-and-cancer/
Gynecologic cancers predict coexisting pelvic floor disorders Publish date: March 30, 2015 https://www.mdedge.com/familypracticenews/article/98401/oncology/gynecologic-cancers-predict-coexisting-pelvic-floor
Life After Cancer: The Role of Pelvic Physical Therapy
https://pelvicpainrehab.com/female-pelvic-pain/2983/life-after-cancer-the-role-of-pelvic-physical-therapy/
American Physical Therapy Association
https://www.apta.org/
Urinary incontinence
https://www.womenshealthapta.org/wp-content/uploads/2013/11/Urinary_Incontinence.pdf
Pelvic Pain
https://www.womenshealthapta.org/wp-content/uploads/2013/11/Pelvic_Pain.pdf
