Incontinence; the Recovery Plan

The Gyno and the Physio

Part 2:

Grateful i had my own plan ‘A’

As mentioned in Part 1 my struggle with incontinence started to effect me more increasingly last fall (2016). Which promoted me to see my family Dr for a referral to a gynecologist. My appointment was in November. As mentioned in Part 1 I had seen improvements by implementing some simple strategies given to my by Angel Growes, a Certified Pelvic Health Physiotherapist. My plan was to start seeing Angela once she was back from her mat leave, however I kept my appointment with the gynecologist because I was experiencing extreme pms type cramping  (as mentioned in Part 1 I don’t have my uterus anymore so this is strange) at times I would rate the pain higher than a contraction.

The Doctor was still expecting me for the incontinence issue so we continued down that path. What she found surprised me. When doing the internal exam she asked me to do a Kegel, waited a second and asked me again. At this point my face was starting to turn red as I tried to intensify my Kegel for her. All this time working on my Kegels and I was doing them WRONG! (More on that shortly).

After completing the exam the Doctor started talking about my options. She first started to talk about SURGERY, to which I interrupted her and said surgery was not an option. So she started to explain the pessary as an option. A pessary is a device inserted into the vagina to provide structural support. It may help prevent urine leakage by supporting the neck of the bladder; it is most useful for stress incontinence. Which the Doctor felt may be my issue. Luckily I already had a Plan A and we agreed to check in after 3 months of Physio.

My Experience with a Certified Pelvic Health Physiotherapist

First off I must say that Angela and I had become closer since our first meeting in the spring of 2017. She was one of the major collaborators for our Her First weekend. So I took extra care in preparing for our first appointment (ladies, you know what I mean!). Angela’s relaxed personality put me at ease immediately. We joked and laughed. She started with an assessment. First taking my history and then checking my spine/structure.

The internal exam took at least 20 minutes. The joking and laughing did not cease during the exam. This time I was more prepared when Angela asked me  to do a Kegel. I had worked on the ‘Blueberry Imagery’, I thought I was going to rock the perfect Kegel. Angela stopped me before my face turned red. I knew I wasn’t doing them right, but I thought I had figured it out since my Gyno appointment. Yep, not so much!  This was when I found out that I’m a tight ass!!

Once Angela explained/taught me how to do a Kegel, it blew my mind how gentle it is and my understanding of it was way off. I was trying to pull the blueberry up to my belly button. In order to do this my inner thighs, anis, glutes, abs… basically every muscle around my pelvis engaged.

How I now do a proper kegel:

The blueberry image is still used. My focus is on wrapping the base of my vagina around the blueberry. More of a pulling the sides together rather than pulling up to my belly button. This is how it works for me, my brain and my structure, I am sure that this is not the case for everyone.

The Exam Results

What Angela found was that when I did a proper Kegel one side was stronger than the other, in fact one side did not fire at all!  The intensity was not where it needed to be. She also found a tight muscle internally that has been causing me hip pain AND I have a Diastasis Recti Abdominis which was never diagnosed!!! Check out our  blog post  from the Wine & Lady Bits Workshop Number 2 for more info about Diastasis Recti.

My home work:

  • Practice a release breath when I inhale lengthen through the pelvis to help relax and release the muscles
  • Kegel maps, I imagine wrapping the base of my vagina around a blueberry. I repeat this activating only the right side, then only the left, 10-20 reps a day. The best time is first thing in the morning or at bed, otherwise I forget.
  • Abs, engage my obliques when doing ab prep. This one blew me away! I was having troubles with low back pain, turns out my obliques did not activate AT ALL. We have fixed that one!!

This is Just the Beginning

I have a ways to go still. This was just the exploratory appointment.  Angela is in high demand and is still working part-time as she eases back from Mat Leave. My next appointment was 4 weeks out, however I received many calls for last minute cancellations. Unfortunately my schedule did not allow me to get in earlier.

So this means more info to come as I continue on my treatment plan. The key is that I keep up with the homework. Like many if us I forget for a few days. The good thing is when I forget, I just incorporate it into our matwork! This is the key to success, doing the exercises your Physiotherapist give you. There is hope, I can resolve this issue without any major interventions.