What a truly biopsychosocial treatment for pelvic pain & interstitial cystitis should look like
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- Опубліковано 8 гру 2019
- Physios take note! I managed to grab a few minutes with Carolyn Vandyken in Amsterdam to discuss her SAD CLLIFSS framework for psycholoigcally informed physiotherapy. This is really where I see the future of all therapy - there are elements within our scope we should be following, and then there's elements we can continually track and refer for help from our colleagues. The Bio is important, but we can't just treat that.
See what you think.
Carolyn teaches her own online course and runs a physiotherapy practice near Toronto: www.physioworksmuskoka.com/ab...
She also teaches some in person courses with Pelvic Health Solutions: pelvichealthsolutions.ca/
I hate to say it but my first response to this was, "Oh b.s." Why? Because I've been a chronic pelvic pain patient for over 15 years and you name the treatment and I've wholeheartedly done it and yet, here we are. You talk about combining psychology therapy, stress training, relaxation, etc as if this is new. But I've been treated with all these therapies - by a team - and more. You name it and I've had it, done it, mastered it, endured it, loved it, been frustrated by it, had high expectations for it, been let down by it. Stress training, counseling, trigger point injections, TP massage, botox, biofeedback, desensitization training, more counseling, more physical therapy, more botox, etc., etc. etc. 15 years of all this crap (and I mean that in the nicest sort of way.) You know what finally stopped the IC and rectal pain? Surgery. You know what they found when they went in there - scar tissue. Tons of scar tissue. Scar tissue that had attached the bottom of my colon to my cervix. Take the scar tissue out and the bladder and rectal pain went away. Three months later - still gone. And you can color me amazingly surprised - at the amount of scar tissue and instant absence of pain in those areas. The vaginal pain is still there though and the ob/gyn tells me those muscles are still rock hard. You know you have rock hard muscles when trigger point injection needles literally bend in resistance. So, I'm headed back to physical therapy and back to the psychologist. Am I optimistic this time? Yesterday - not so much. Today - I'm ready to take it on, fight those little muscle devils for all they're worth. I just wanted to say that be careful about grabbing onto this new approach for all it's worth. You might be missing something. From a real-life "zebra," I can tell you that sometimes when you get tunnel vision about a medical approach, you might be missing something. I've had it happen to me more than once. "It's just cramps" -- "Oops, sorry, adenomyosis." / "It's just an increase in ocular migraines, are you more stressed?" -- "Oops, we had no idea it was warning of an impending CRAO, sorry you lost your eyesight in that eye." / "It's just heartburn...sometimes people do get heartburn every day...change your diet." --- "Oops, SCAD is so rare but you lived through it with only 30% damage." I realize medical professionals aren't perfect and can't know everything. But one thing I do know without a doubt is that just like everyone, they can get tunnel vision with an idea. Fight against that with pelvic pain patients. Please.
Thanks so much for sharing, that's a really important experience. I totally agree, my patients are always initially seen by the urologist/consultant and have a full work up. I tend to see people who have already had multiple operations to no avail. It's a BioPsychoSocial approach - that always includes the Bio.
@@jillybond1502 Yep, I agree that a urologist is always good to see in the beginning. I went to one of those too. Actually, I went to one of those because my internal med doctor sent me there after my 3rd ob/gyn wanted to put me on hormones and I didn't want that. So the internal med doctor had me go to a urologist. Not a great experience at the time - that bladder filling test blew the pain up for days and he didn't see anything anyway. But then again, back 15 years ago, it was almost dinosaur medicine treating PP patients if you know what I mean. I do agree with the team of medical and psychological professionals approach. Just as long as everyone doesn't assume that because patient A has anxiety, that's what is causing all the pelvic pain. PT reduced pain but then it didn't anymore. It's a vicious cycle. I will beat this. Then I'm going to do road trips like you wouldn't believe - like they just finished the interstate highway system and I have a pretend convertible. Thank you for replying. I really appreciate that you took the time to read my up-on-my-soapbox rambling.
@@ferocitas1958 I am curious, had you had any abdominal surgeries prior to the one to remove the scar tissue? I am wondering if it was scar tissue due to prior surgeries or if your body, like mine, had a tendency to form adhesions. I wonder if this may be the cause of my IC. Thank you for your post, most interesting
Great video - of course the biopsychosocial approach is not at all new - but I love the framework Carolyn uses and this pneumonic for helping to think about all the different components of the "psychosocial" side.
Hello Jilly. Really enjoyed your videos. I have been wondering if PBS is the same as overactive bladder syndrome ? My doctor has told me about bladder training
Does this also work for PBS?
Pelvic PT here! Where can I learn more about Carolyn's SAD CLLIFSS framework? Would love to start implementing this in my practice.
Carolyn's online live course is available throughout the year - I'd get in touch with her to learn more: www.physioworksmuskoka.com/
@@jillybond1502 Thanks, Jilly! I will contact Carolyn.
Wow but what if it’s all the result of a medical injury or adverse response to pharmacy ?
SAD CLLIFSS!!!