Pelvic Floor Rehab

The past 5 1/2 months have been discouraging. I haven't felt well but medical appointments stretch out taking weeks between appointments and procedures. 

The end of March I went to an urgent care facility in Warsaw with painful urination and blood in the urine. I assumed I had a urinary tract infection. I have had these occasionally for probably 10 years. This time the gross hematuria appeared as tea-colored urine and the testing showed no infection. I was told I should see a urologist for a cystoscopy to make sure there were no tumors or bladder stones causing my problem. Meanwhile, though most of the pain went away, I felt like I needed to pee all the time; 30 minutes after voiding, I felt like I needed to use the toilet again. 

To shorten a long story, after seeing a gynecologist who checked for prolapsed pelvic organs, I finally saw a urogynecologist in Fort Wayne toward the end of May. Two weeks wait for urodynamics study, 5 weeks wait for the cystoscopy. No advise or suggestions on how to cope except I was given a collection/measurement device and a voiding diary to fill out over a two-week period. Sounds simple, doesn't it? But are you going to haul a large plastic collection container to the grocery store with you? To church? I was to measure all urine voided. 

The good news is that there were no abnormalities inside the bladder. The urodynamic studies showed overactivity. I was prescribed oxybutynin. I took it for 15 days. Horrible stuff! I already had a dry mouth from my allergy medication. This made it worse. I started chewing gum often. Dry eyes were bothersome. I used eyedrops. The constant severe heartburn, even using meds, was the clincher. I discontinued using oxybutynin. I read on the internet that 70% of women who try this drug, stop taking it because of the side effects. We could have tried Vesicare I suppose, but it has similar side effects and is very expensive. Medicare tells doctors to try oxybutynin first as it is cheap. The medicine didn't improve anything for me as far as I could tell. I was still on the lookout for toilets, and leaving the church service to visit the bathroom. 

I was referred to pelvic floor rehab. A specialized physical therapist is part of this urogynecology practice. Of course, I had to wait several weeks for an appointment. At the first appointment, I was told that though there were things to try, Medicare requires 30 days of Kegel exercises before they will pay for these other things. So another month was going to pass. As it was, after 12 days of Kegels my condition worsened. Not only was I having frequent urination, I had intense pelvic pain which kept me awake at night despite taking Aleve, and was unable to get to the bathroom at night without leakage (which was not an issue before). I had been told to phone if there were problems. The therapist was unavailable but my experience was relayed to her. Stop the Kegels. We had made a good faith effort, but I was one of those persons who was not ready for Kegels yet.

This past week I finally returned to Pelvic Floor Rehab. A device was inserted in my vagina. It measured resting muscle tension. Normally, a woman would have 3 or less. I was 4.5. Though my pelvic floor muscles were weak, they were also tense, which is why the Kegels were the wrong exercise to do at this time. I was given a course of pelvic electrical stimulation. There is no medical consensus on how effective this procedure is. Medicare will only pay for it if there is incontinence. Congratulations, I now had that problem due to the Kegels. (Though actually it did clear up after about a week of stopping the Kegels). 

Pain is probably too strong a word to use, but receiving timed electric shocks for 20 minutes certainly is not pleasant. I don't return for 2 weeks. I have some yoga exercises for pelvic girdle to do at home. I have been trying to retrain my bladder to wait longer and longer. I can now wait 2 hours though I do have some discomfort. Both times I visited pelvic floor rehab, they did a post-voiding residual test. I am definitely not emptying out normally. The therapist even used a catheter before the e-stim procedure as the bladder needs to be empty for that.

I am finding out that bowel problems of the past decade are probably related to the pelvic floor tension, also. Intermittent pelvic pain also probably related. Whether my pelvic floor problems can be fixed remains to be seen. 

Most post-menopausal women are aware of prolapsed (sagging) pelvic organ problems. Well, weak pelvic floor muscles cause problems even without prolapse. I have been told that eventually we will try the Kegels again. They are a good maintenance of muscle strength once we get there.

So time drags by. Much of my spring and all of my summer spent in a state of unwellness so to speak.