Monday, September 9, 2013


Here's a testimony from one of our Pelvic Floor patients that was too good to keep to ourselves. 

I didn't have a life. That is, not much of one.  Sadly, I'd lost the ability to do many of the things that I enjoyed and that helped make life fun and meaningful. And THAT was because I'd lost the ability to do one of life's most basic tasks...I couldn't pee.

I assume, if you are still reading this, then something similar has happened or is happening, to you.I was in my office when I first realized I couldn't pee. Quite a shock. Quite uncomfortable. Quite a trip to go to the ER and have a catheter installed. That lead to medication to deal with my enlarged prostate that was, apparently, blocking the flow of urine down my urethra. It worked well for many months...until it stopped working well and I was back in the ER. This time my urologist recommended TURP surgery, a laser procedure to reduce the size of the prostate and open things up. Till it could be scheduled I had to wear the catheter. That meant no running, no sports, no working out, difficulty sleeping, occasional discomfort, and walking slowly.

Then I had the surgery and all was well...for about 2 months. And then the same problem returned. My urologist kept saying he didn't understand, the prostate was no longer squeezing on my urethra, it must be that I was doing something wrong, I must be getting too anxious and tightening my sphincter and preventing the urine flow.

So, apparently, it was all my fault for being too anxious. So we tried a few different anti-anxiety medications. I took them and he took the catheter off. And a few days later I couldn't pee and it was back to the ER. After some tests they could find nothing amiss, my urologist recommended redoing the TURP. We did. Nothing got better. By now I was getting recognized on my return visits to the ER.

Life had become nightmarish. I decided to try something different.

I went to another urologist who specialized in difficult cases. He recommended that I learn to self cath when needed. That way I could avoid ER trips and not have to wear a catheter. It was the scariest thing I ever heard of. No way I'd EVER do something like that! But what was the alternative? So I learned it and it was painless and no big deal.

And I told him I wanted to try physical therapy. He agreed and gave me a few names. I called around and that's how I ended up at Duffy and Bracken. Lucky for me!

I began seeing Ann Duffy twice a week. In the evaluation she used a biofeedback mechanism to measure the strength of my Pelvic Floor Muscles. I didn't know I had a Pelvic Floor nor did I know that there were muscles there. Turned out they were extremely weak. She could also measure their ability to relax. Turned out they were not very good at that either. My pelvic floor muscles were under strength and over tense. "You have pelvic floor dysfunction," Ann told me, and traced it back to surgeries I'd had in the area some years ago. She explained that, because the muscles are weak, they had to work extra hard to keep me from being incontinent. As a result they were in a constant state of tension. And that is what lead the muscles to over tighten at the wrong times and prevent me from being able to pee.

We had a theory on what was wrong that went beyond telling me to relax or giving me anti anxiety medications! And that lead to a theory of what would help: Strengthen the pelvic floor muscles and supplement that with relaxation techniques.

So that's what we did. I learned Kegle exercises (though probably not how to spell them correctly) that I did both with Ann and on my own as well as other exercises I could do at home. Using biofeedback we could measure the muscles' strengthening and also see what relaxation techniques worked best for me. We found deep belly breathing did the trick.

Things did not immediately get better. I had to self cath a number of times. Sometimes I felt pretty discouraged and anxious. Ann was encouraging but also action oriented. "What good does getting anxious serve?" she asked once. We got back to the Kegels.

Then things improved significantly! I had a long stretch of feeling fine. When I had a rough few days, Ann quickly figured out the problem...I'd hurt my lower back lifting some boxes I shouldn't have. The muscles there tightened and that caused surrounding muscles to also tighten...including those pelvic floor muscles. So Ann gave me stretches to do and then strengthening exercises for the area. Things have gotten better again.

I think the best thing I can say about my work with Ann at Duffy and Bracken is that it is individually oriented and self empowering. That is, what she did is figure out what was going on with ME and then devise exercises, stretches and relaxation techniques that enable me to vastly improve and, hopefully, remedy the problem. NOT oriented at all (at least in my case) to medications and that is something I think is a very good thing. They almost always have side effects.

Duffy and Bracken is a business and I'm sure Ann is a good business woman. But everyone knows that physical therapy can take a while and that can be expensive and cause people to shy away. But what I found with Ann is that she'll do her best to work with you, to use your insurance, to come up with something fair should the insurance stop helping or be unavailable for whatever reason.

I'm very happy with what I've accomplished with Ann's help. I'm back to my active life. I'm pretty confident that you will improve things, probably greatly, if you work hard and consistently with the folks there.

I'd be happy to talk to you about all this if you think it could be helpful.

Michael Leiman