Guest Column: A search to find help for a
women’s health issue no one wants to talk about
For a number of years, I was embarrassed to
talk about my
debilitating health issues. That’s what I called them –
We live in a polite society, and it is uncomfortable for most of us to
have our most personal bodily functions and ailments made public and
certainly to speak of them was unthinkable to me.
The product of an emergency room nurse and a former prisoner of war, I
grew up learning not to whine or complain and to remember there is
always someone worse off than I. Compared to many others, I
in good shape so it was unseemly on several levels to discuss my health
The health issues finally rendered me practically non-functional and
struggling with low-grade situational depression. I became
housebound and completely unreliable as far as appointments or
commitments were concerned.
Traveling anywhere was so difficult that we traded our vehicle in for a
mini-van so I would have a place for a small camper toilet.
then, it wasn’t easy and I left home only when it was necessary.
The reason? First, urinary problems, and then bowel
so severe that I spent most of my time in the bathroom and never slept
more than two hours at a time. I had a great deal of pelvic
and I hurt with almost any activity I undertook.
It took more than five years and several doctors from Elizabeth City
and Greenville, Suffolk and Norfolk, numerous tests (some pretty
gruesome), two colonoscopies, and surgery to resect my rectum before
the cause of my problems was diagnosed.
I was told, “Drink more water,” “Eat more fiber,” “You have IBS
(Irritable Bowel Syndrome)and there is no cure,” and “There is nothing
wrong with you.”
It was demoralizing and degrading.
Everyone was looking in the area of the obvious immediate problems and
didn’t consider the common denominator - the pelvic
Two years ago I changed gynecologists. I surveyed women whose
judgment I trusted and Dr. Dan Dwyer’s name came up
When I first saw him in his Nags Head office, I didn’t go into detail
about the problems I was having. I was so tired of talking
it and hearing the same litany of what I now, rightly or wrongly,
considered excuses for the doctors‘ lack of compassion and
But by my second annual visit, I was ready to plead for help.
Dwyer knew something was not right and he gave me the opening I needed.
When Dwyer was unwilling to do a manual examination that caused me
pain, he brought me back in for an ultrasonic examination and a lengthy
and straightforward yet sympathetic discussion.
Dwyer’s diagnosis was a neuromuscular dysfunction and he wanted me to
see a urogynecologist. I had never heard of a
and my job was to research and locate such a specialist using criteria
he set forth and get back to him with my findings.
That was very good for me. It gave me some control, finally,
my path to eventual normalcy.
A specialist at Duke seemed to me to have the best credentials, so I
sent Dr. Dwyer the link and he quickly responded that he agreed.
I made an appointment and in just a few weeks I was seeing Dr. Alison
Weidner in the Urogynecology Division of the Department of Gynecology
at Duke University Hospital in Durham.
She spoke with me extensively and conducted a detailed physical
examination. Her conclusion was a confirmation of Dwyer’s
diagnosis -- officially, levator spasm with dispareunia.
Simply, my pelvic floor muscles were in chronic spasm, shortened and
tightened so much that they were unable to relax. That
in painful sexual intercourse, constant pain in the pelvic area,
alternating constipation and diarrhea with urgency, and frequent
The doctor’s prescription was a course of a muscle relaxant
specialized women’s health physical therapy. The medication
not a problem to obtain here on Hatteras, but the physical therapy was
not going to be easy to locate.
She gave me a not-very-long list of physical therapists across the
United States who were specialists in women’s health but presented it
to me with a caveat: “You live on the edge of nowhere
village) and there is no one nearby that we can recommend.”
No surprise but still disappointment. There was help, but it
not available to me.
Well, I would not give up. I would find someone who would
now that I knew what I was looking for.
After an extensive search, I located someone in St. Petersburg, Fla.,
close enough to my sister’s house to be a possibility for me.
I went with Chobe, our dog, but not with my husband, Ernie, who was
keeping the business going, for two months of therapy in an easily
accessible place, only a15-minute drive from her house.
It was a very positive experience. I was slowly feeling
improvement, and I would gladly have stayed for however long it took to
achieve relief. But after two months of treatment (three days
week), the season was about to begin in Hatteras, and I had to return
home to our business. I was not ready, but there was no
Ernie flew down to drive us home. It took five days because I
been ordered to stop every hour to stand and move.
got back, I soon found myself slipping backwards and was again faced
with the original challenge -- where could I get help?
My spirits dropped, and my hope began to fade. One day my
friend and editor, Irene Nolan, called to ask if I had read the
supplement that Albemarle Hospital had placed in a local
In it was a notice of a new service – women’s health physical therapy.
Elizabeth City is a long drive for me, but my initial therapy had left
me capable -- sort of -- of the trip. At least, I was more
than I had been earlier. So I made an appointment and began a
The staff was warm, professional, and respectful of my
In the early days, several of the professionals (Tracy, Susan, Kristin
and Johnna) weighed in with their assessments, their specialized
treatments, and their advice. In addition to the pelvic floor
dysfunction, my body was misaligned and there was tightness where I had
surgical scars and fascia that had hardened. All were
I felt heartened by their collective concern and, more than that, their
determination to make me whole again.
I have been working primarily with Kristin Everette for months now. She
has designed plans specifically for me, taking into account my weekly
progress. During our sessions Kristin encourages me as she instructs
and demonstrates each exercise and explains what the exercise is
designed to do.
Kristin is a fine-tuned professional who is passionate about her
work. She displays natural warmth and humor that make me feel
comfortable and confident and not the least embarrassed.
With her help, I am making big improvements again.
I have flare-ups once in a while and can expect that. I
have a bad day or two after I have practiced new, more advanced
exercises. But the good days outnumber the bad, and I have
experienced very little pelvic pain for a number of weeks.
After many years, I can now take daily walks, work on the elliptical
trainer, and can once again enjoy throwing a ball for my dog.
practice some restorative yoga and dutifully follow my plan.
make time for at least 15 minutes of daily meditation.
The exercises are actually relaxing. They are prescribed to
lengthen and relax the pelvic floor muscles and are not intended to
make me skinny, so my focus is always relaxation, not “burn” or
Kristin has recently introduced some introductory Pilates exercises to
help me begin to strengthen my core and even they are not brutal -- yet!
I begin and end each session with diaphragmatic breathing exercises and
enjoy soothing music. I realize I am developing a refreshing
attitude about my body and my psyche. I now know that I hold my stress
in my pelvis and I am learning to recognize when that occurs and relax.
There are so many people who can benefit from this treatment:
older women who have been told that “leaking” when coughing, laughing
or hitting a golf ball is just a part of the aging process, women told
they have IBS and there is no cure, young athletes , particularly
gymnasts, and ballerinas, struggling already with straining.
too, can benefit from targeted physical therapy.
I wish I did not have to go to Elizabeth City from my home in Hatteras
village. It is a long round trip. Last year it
been an impossible journey with all the benefits of therapy wiped out
by the difficulty of traveling in my condition.
Several weeks ago, I called Anne Thomas, the director of the Dare
County Public Health Department. She is a woman who
whom to call, where to look, and how to go about getting things
done. I explained my situation, expressed my concern that
women here were not even aware that there was help available, and asked
her to direct me to the right person to contact about getting this
service here on the Outer Banks.
The next day she phoned and asked if she could give my name and number
to Janet Jarrett, the administrator of Regional Medical Center in Kitty
Hawk, with whom she had conferred.
The following day, I received a call from Janet. She was
supportive and wanted to explore the possibility of bringing therapists
from Albemarle Hospital, their affiliate, to Regional on a once or
twice a week basis.
She organized a Lunch and Learn series on the topic at Regional every
Tuesday in October, and there was interest.
As you can imagine, economics enters the equation. There must
a need to support the service. So they must evaluate the
potential before the implementation.
It is certainly possible. Michelle Deppish, the director of
Rehabilitation Services at Albemarle Hospital is, along with Janet,
enthusiastic about bringing women’s health physical therapy to the
Outer Banks, as are two wonderful practitioners who have helped me so
much, Kristin and Susan.
The professionals are ready to go, and here is how you can help
I completely empathize with anyone’s initial hesitance to speak up, but
I ask this of you -- make the initial call.
A phone call to Michelle Deppisch or any of her staff will be handled
discreetly and empathetically. You may be surprised how
comfortable they make you feel.
They have helpful hints for talking with your doctor that, believe me,
I wish I had years ago. They have forms for keeping a daily
record of your symptoms and a self-assessment quiz for you to help you
paint a full picture for yourself, your doctor, and your
If you are like me, in time the condition becomes your ”normal,” and it
is hard to quantify the symptoms after a while. But don’t be
intimidated. Just answer the best you can. The
staff knows how to ask questions that give them the information they
need to help you.
However, if you do not yet feel comfortable calling the unit, please
e-mail me or phone me and let me know that you feel you could benefit
from women’s health physical therapy.
I promise to honor your anonymity. I will never divulge your
and contact information unless you tell me it is okay. You
even have to tell me if that is easier.
It will be my pleasure to talk with you and discuss my experience, and
I want only for you to find the relief that I have been
Be aware that you will need a doctor’s order for physical therapy, so
it is important that you ask for this treatment. You may have
do a little educating, and we can help you with that. Answer
these few questions and discuss them with your physician:
1.My last pelvic exam was ----- (days, weeks, months, years) ago.
2.I have ------ child(ren) and delivered ----- (vaginally, by cesarean
3.I’m having some or all of the following symptoms:
a.Pain, pressure or a bulge “down there”
b.Trouble urinating or passing a bowel movement
c.“Leaking” or needing to use a bathroom often
d.Pain during urination
4.My symptoms started ----- (days, weeks, months, years) ago.
5.I have these symptoms ----- (daily, a few times a week, sometimes,
6.I want to find ways to treat or cure these symptoms.
7.Is he/she aware of the progress being made in women’s heath physical
There are many of us with these problems. I know that
Please let us help you to help yourself.
Department of Rehabilitation Services
1144 N. Road Street
Elizabeth City, NC 27909