Purpose Statement

This blog is intended to educate women on issues that affect women. Although we are all healthcare professionals, we are not here to give medical advice. Rather we hope this will encourage women knowing that help is available and give them the courage to seek help.

Friday, March 8, 2013

Friendship and Healing

Since you are experiencing a chronic pain condition, there comes a realization that total healing may not occur.  Despite all that health care providers do for you and all that you do for yourself, your condition persists.  In fact, it can become all consuming.

Looking outside of yourself to avoid isolation is an important element in staying connected to life and the world.  Friendships are one of the best connectors, and it is surprising to learn how many women feel they have few or no friends.  As a therapist, it is not uncommon to hear women talk about the difficulty they have in meeting others and developing friendships.

Researchers attribute the lack of friendships to introversion, increasing remoteness because of technology, especially texting and email, and changing neighborhoods where safety and air conditioning systems deter us from meeting the people we live closest to. 

Changing roles of women also contribute to the lack of friendships.  Where a century ago, women participated in quilting bees, sewing circles and pie baking contests, women today find themselves challenged by balancing family, work, their professional careers and physical activity.

Laughter, sharing, commiserating, empathizing, suggesting, hugging – all of these actions are healing. In our highly technological society, it is interesting how many of us are spellbound by reruns of old television shows from the 1950’s and 1960’s.  If you were to analyze the story plots, it is the relationship between friends that is the key to the story line.  Clients often say that “I Love Lucy” is their favorite classic television show.  Zany Lucy and Ethel create untenable situations in the series, yet and no matter their misadventures, their close relationship endures. 

The psychological and physical benefits of friendship include reduction in stress and increases in endorphins, the substance our bodies create to form a feeling of wellbeing.  Loneliness causes people to be more restless, sleep less, and be more irritable.  It causes changes in appetite and may contribute to slovenly behavior.

Despite chronic pain, there are relatively easy ways to seek out friendships.  One guideline, is to reach out to others whom you know and initiate contact.  Send a greeting card, offer an invitation to lunch, or ask if you can drop by and deliver your favorite cooking creation as a way to say, “I’m thinking of you.”  Even if you are introverted, these actions are not demanding.

Other ideas for connection include volunteering for a cause that is dear to your heart.  If your mobility is compromised, charities have jobs that can be performed at home, and you receive contact and recognition for your actions.

Consider getting a pet.  Besides the therapeutic value of having a furry warm body, pets generate conversation.  They also help you gain entrance to groups of similar interest.  Walking your dog, helping at a shelter, socializing a dog for therapeutic use by an impaired child, are ways to open doors for making new contacts.

Joining a support group related to your condition gives rise to new associations.  However, if the group lacks educational structure and is filled with angry, bitter members, you may want to seek out a gathering that is more uplifting.

Dare yourself to develop a new hobby and involve yourself in a special interest group.  Ask for help, offer to do a favor, or accept a position on that organization’s administrative Board.

Take a class.  Learn something you have always wondered about.

Be expressive!  Be inviting!  Smile!  Remember you ARE NOT your pain.  Let the personable you shine.  Trust that others will respond positively.
 
By: Rhonda Borman, LCSW

Saturday, November 3, 2012

WHAT IS VAGINISMUS???

Vaginismus is the involuntary tightening of the muscles that surround the opening of the vagina causing penetration to be painful or impossible.  Vaginismus may result from a combination of physical or non-physical triggers that cause the body to anticipate pain with vaginal penetration.  The body reacts to the anticipation by automatically tightening the vaginal muscles to protect itself.  This sets off a cycle of pain which is difficult to break. 

With vaginismus, the mind and body have developed a conditioned response against penetration.  The body has learned to expect pain with vaginal penetration which causes the pelvic muscles to contract to protect against potential pain.  It is something that happens automatically.  The problem is that tightening of these muscles actually causes more pain instead of protecting from pain.  The contraction or spasms of these muscles causes pain or burning with penetration and may even prevent penetration all together.  Many women complain of difficulty or pain with tampon insertion as well as pain with intercourse. 

Retraining the pelvic muscles to respond differently to the anticipation of vaginal penetration is the key to treatment.  It is important that woman learn conscious control of these muscles.  There are both body and mind components to consider in the treatment of vaginismus.  The goal is to resolve any triggers so that when penetration is attempted involuntary spasms no longer occur and pain is not present. 

You may have also heard the term dyspareunia.  To clarify, dyspareunia simply means “painful intercourse”.  It is a general term to describe any type of sexual pain.  This pain may occur with vaginal penetration, during intercourse or after intercourse.  There are several causes of dyspareunia and vaginsimus can be one of the causes.  Vagnismus is specifically characterized by involuntary tightening of the vaginal muscles with penetration. 

One tool that is often utilized in the treatment of vaginismus is vaginal dilators.  A pelvic floor physical therapist may recommend a home vaginal dilator program designed to eliminate the involuntary pelvic floor muscle contraction that occurs with penetration.  Through the proper use of dilators, women can develop control over the involuntary contractions and decrease the pain associated with penetration.  Some women may use the dilators for other purposes such as rehabilitative stretching of tissues post surgery or as a result of age related hormone changes. 

If you are having difficulty or pain with any type of vaginal penetration talk to your healthcare provider.  Please don't assume it is normal or that it is something you just have to live with.  Seek the help you deserve:)

Sunday, October 7, 2012

Vaginal Hygiene Products that should be Obsolete

Walk through your local pharmacy, and you will find at least a full aisle dedicated to women’s health products. Some of these products can make your life much more clean, comfortable, and healthy – tampons, sanitary pads, vaginal lubricants, and condoms to name a few. There are ovulation predictor kits to help you determine when you are most fertile, and there are pregnancy tests to tell you when don’t need to use those ovulation predictor kits anymore. But do not be tricked into thinking that all of the products on those shelves are necessary, or that they are even good for you. There are a few over-the-counter products that I think can actually cause harm to women and should be removed from the shelves forever. But, before we talk about those products, let us quickly review the vaginal ecosystem.

The vagina contains lactobacilli – “good bacteria” – that produce lactic acid and maintain an acidic environment. This keeps “bad bacteria” from colonizing and causing infection. The vagina is self-sustaining and self-cleaning. It does not require maintenance to keep it healthy.

The healthy vagina produces fluid and mucus that constantly bathes the vaginal walls, removing dead skin and keeping the tissue lubricated.  All women experience some vaginal discharge as this fluid exits the body. Normal vaginal discharge is clear or creamy white, it usually has no odor, and it does not cause discomfort. This discharge is a normal function of vaginal hygiene.

When a woman experiences that “not-so-fresh feeling”, it probably means she is having a discharge that itches, burns, or has a foul odor, and these are signs of infection. Getting the vagina back to normal usually requires a prescription  - not an over-the-counter spray or cream that will mask the symptoms. If you accidentally chopped off your finger, would you try to put it back on using band-aids? Probably not. But, this is what you are doing when you “just don’t feel like yourself” and use an over-the-counter douche or cream.

Which brings us to that list of over-the-counter hygiene products available to women that mask symptoms and serve no purpose in maintaining a healthy vagina:

Douches

I will say it again: the vagina is a self-cleaning organ. It does not require regular rinsing with a douche – scented, unscented, vinegar, any kind. Vaginal douches rinse away the lactobacilli that keeps the vagina healthy, removing your body’s natural defense system. If you didn’t have an infection already, then you probably will after douching. If you are just not feeling that fresh, then you are better off seeing your Ob/Gyn provider because chances are, you need a prescription.

Vagisil

If you are itching, you have an infection; it is called vaginitis. Vaginitis can be caused by yeast, bacteria, or a sexually transmitted disease. See your Ob/Gyn provider. She can properly diagnose you and get you the treatment that you need. Vagisil just takes care of the symptoms, not the infection.

FDS Spray

Again, if you have an odor that has to be covered with a scented feminine spray, then you probably have an infection. Not to mention the fact that the vulva – the exterior structures of your anatomy – is very sensitive to scents and dyes in products. Spraying a perfumed deodorant on your vulva can cause irritation and make your situation worse.

Any Scented Body Wash or Feminine Wash

See FDS Spray above.

Bottom line: if you feel like you need to deep-clean, deodorize, or calm an itch, don’t hit the pharmacy. Call you health care provider. Chances are, you need more than just a bandaid.
 
Written by: Laurie H Lee, WHNP

Wednesday, September 5, 2012

Women, Sex and Fantasies

It seems that every TV talk show host these days has something to say about Fifty Shades of Grey.  And this book and its sequels by female British author E. L James continue to fascinate women throughout the world. 

The author openly states that her book reflects all the romantic and erotic fantasies she has had during her life time.  The heroine is young, beautiful, witty, curious, smart and healthy.  Her attraction, Christian Grey, is handsome, rich, articulate, desirous, solicitous and most of all, controlling.

While the book is not a “must read” for everyone, its popularity is a reminder of the important role that fantasy plays in a woman’s sexuality.

Fantasies are one of the key aspects to sexual arousal, and can be powerful motivators whether they are unspoken mental images or acted out between consenting partners.  Mental images can serve to augment sexual response without feeling anxious or guilty. They allow the person to envision different scenarios within the container of their imagination. 

When acting fantasies out, discussing their significance and the roles each partner will play is important.  The goal is to enhance the relationship between the couple and to deepen their emotional connection during and after sex.

Setting boundaries and having a safety word that stops the action and protects the partners is equally essential. Physical abuse and statements that cause emotional pain do little to create long term sexual satisfaction.  In fact, the effect is usually emotional distancing that often ends with denial of sexual participation and even separation and divorce.

Fantasies among women and men differ, with some seeming bizarre to the partner.  When sharing a fantasy, it is helpful to say that it can remain only a fantasy and not be acted out.  This also enables couples who choose to share their fantasies to be non-judgmental.  Fantasies may change with age and maturity, and the longer the relationship continues, the more this change may be noted.

Most health care providers are at ease in discussing issues regarding sexuality and fantasy with their patients.  Providers also may suggest their patients see a counselor whose schedule allows for extensive discussion of this matter in a safe environment.
 
Rhonda Borman, LCSW

Sunday, August 5, 2012

Constipation

Do you suffer from constipation? When you have a bowel movement, do you feel completely empty?  Normal bowel movements are different for everyone.  Some people go after every meal and some go every other day.  The important thing is that you get that good feeling of completely emptying.  Bowel health is important for your over all well being, bladder health, and your pelvic floor health.

There are three main things that may be contributing to you not emptying all the way. 


1) It may be a motility problem.  Sometimes our colon gets lazy.  The job of the colon is to contract and push the stool along.  Hormonal changes, dietary changes, change in medications, or changes in activity are some factors that may affect the motility.  What can you do about it? Gentle abdominal/colon massage techniques can help wake up the colon and motility.  Find your local women’s health physical therapist to learn how to do this.  Also, exercise can help improve the motility.  Movement is great in helping wake up your colon!
2) It may due to your diet.  Your colon LOVES water.  Without enough of it, your stool gets harder and more difficult for your colon to pass.  Your colon also feels the same about fiber.  A balanced diet with plenty of water helps to keep your colon happy!
      3) It may be an outlet problem.  Let me explain. . . .Do you relax when you sit on the toilet? Are you straining to have a bowel movement?  If you are holding your breath, your muscles around your anus and rectum can’t relax and it makes it more difficult for the stool to get out.  Make sure you take deep breaths and think about your pelvic floor muscles relaxing.  Take the time to sit, relax, and completely empty.  Try not to rush it.  Your colon likes for you to be relaxed.

      There may be other factors contributing to your constipation besides those listed above.  But in general, drink plenty of water with a balanced diet, exercise, and make sure you take the time to breathe, relax, and have a bowel movement.  More importantly, if you are suffering from constipation, consult your medical practitioner.

Sunday, June 10, 2012

Urodynamics Study

Your provider has told you that you need a urodynamics study (UDS) but you have no idea what that means.  You’re scared and thinking of canceling your appointment.  Before you cancel, keep reading to learn more about the procedure.

What is a UDS and why is it performed?

A UDS is simply a bladder study.  Your provider can gain very beneficial information from this study and it can help guide treatment plans.  It can help determine if medication or a surgical procedure is appropriate for you. 

Is a UDS painful?

No it is not painful.  You may experience some urgency to urinate or some mild discomfort with urination after the study, but this resolves quickly.

When can I resume normal activities?

You can return to all your normal activities on the same day.  Sedation or anesthesia is not required to perform the study.

Can I eat and drink before or after the procedure?

Yes, there is no limitation or restrictions regarding diet.  Your provider may ask that you do not increase your fluid intake prior to the study, but will not likely limit your fluid intake.  Please discuss with your provider regarding fluids the day of your study as each practice has their own requirements for the study.

How long will the study take?

The procedure itself varies in length of time depending on your bladder function.  You should plan on being at your appointment for 1 – 1 ½ hours.

Questions to think about prior to study:

How often do you void (urinate)? ex: every hour, 2 hours,  10 times per day

How many times do you get up at night to void?

Do you leak urine?

If you do leak urine, when does it happen?  Trying to get the bathroom on time?  With laughing, sneezing, and coughing?

Do you push or strain to empty your bladder?

Do you have urgency (gotta go, gotta go)?

If you are having a urodynamics study be sure to discuss all your questions and concerns with your provider.  Knowledge is power and can help alleviate your concerns.

If you are having bladder issues, be sure to see your provider as there are treatment options available.  If you are not sure where to start, talk with your primary care or family provider.  He/She will know where to refer you for evaluation and discussion of treatment options.

Saturday, May 5, 2012

EXERCISE FOR A BETTER YOU!

Does every day seem like a struggle to you?  Do you ache all over?  Do you feel like you have worked a 12 hour day and it is only 8:00 in the morning?  Has pain taken over your life? Many people suffer with chronic pain and it can take over your life physically and emotionally.  One thing that has been proven to help people deal with chronic pain is EXERCISE.  I know some of you are thinking, “How can I even think about exercising when it is hard enough just to get out of bed and get dressed in the morning?”! The idea of exercising when your body aches may seem impossible but please keep reading and I hope you will realize it is not impossible and may just be what is needed to break that vicious cycle many of you are in. 

We all find ourselves in a slump sometimes.  Some time ago I realized that was exactly where I was…in a slump! I was 20 pounds heavier, tired all the time, little problems became big problems in my mind and my body ached all over.  While this is nothing in comparison to what many of my patients and many of you face on a daily basis it was something that was affecting my quality of life and I made the conscience decision to do what I was capable of doing to improve my quality of life.  We hear it everyday….EAT HEALTHIER AND EXERCISE! As a physical therapist I talk about the benefits of exercise and recommend various exercises on a daily basis.  What I was not doing was practicing what I was preaching! Once I started making a conscience effort to improve my diet and make exercise a part of my daily (or at least every other day) routine, I started noticing changes immediately.  I started to feel better, have more energy, have more patience and less pain.  I have experienced first hand the changes that exercise can make and I hope you will consider the benefits of exercise in your life. 
Getting motivated to exercise isn’t easy….even when you feel fine, but even a little exercise can help to decrease pain and improve your health.  The less activity you do, the less your body becomes capable of doing.  Eventually, simple tasks can become tiring and painful.  You hurt so you don’t move and a vicious cycle is formed.  Adding gentle exercise to your daily routine can help to break this cycle.  Too much activity can make symptoms worse in some cases BUT so can inactivity.  Water exercise can be a great option for someone suffering from a chronic pain syndrome.  The water supports the body and relieves pressure on the joints.  Movement is easier in the water and many people have discovered that they can exercise pain free in the water.  Another great option for many people is yoga.  Gentle yoga increases strength and flexibility as well as introduces you to deep breathing and meditation which can be very beneficial in controlling pain. 
If you have not been physically active, I would suggest you consult your healthcare provider or a physical therapist before you begin to help you decide what kind of exercise is most appropriate for you.  Chronic pain can make every day seem like an uphill battle.  Exercise can help to change the way you cope with pain mentally and emotionally.  I know it is not easy but it is so worth it!