Why I specialize in pelvic health

At least a few times a week, I get the question, “So, what in the world made you want to do this??” And it’s fascinating on a lot of levels. First, there’s the assumption that “this” meaning, my profession, is a strange and weird specialty to be in. (I could write a whole post on that topic, but I won’t…at least not right now.) I doubt my colleagues practicing in Orthopedics or Neurology get that question with that look as frequently as I do. Generally, there’s the assumption that I must have had a pelvic problem that was treated by a pelvic PT, that inspired me to move into this specialty. Also, not true. Although it could be (and who knows what will happen in the future, with this little sweet one on the way in October!!), and that would be inspiring, I’m sure, but it’s not my story.

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Sweet Baby Reale, due in October!! 🙂

The truth is, I sort of fell into the pelvic health world. I remember clearly when I first learned that there were physical therapists who did vaginal and rectal examinations. I was a first year doctoral student at Duke, and we were in the midst of our very first clinical experiences– observing for one afternoon each week at various physical therapy clinics and hospitals around the area. A few of my fellow students were assigned to “Women’s Health” (I was not). We all sat around as they shared in horror their experience of watching a physical therapist do an internal examination, and I stated, pretty clearly, “Wow, that is so gross. Why would anyone ever want to do that?!”

Yet, here I am, dedicating my career completely to this population. At the time of first-year Jessica in PT school, I was positive I wanted to specialize in Vestibular Dysfunction and Neurology. I had interned at a clinic for 2 years in undergrad that specialized in this population, and I loved it. The problem was, Duke required that one of our long internships (5 months long to be exact) be in the Orthopedic realm. So, not knowing what exactly I wanted to learn about during that “unnecessary” second internship, I made my list of “split” affiliations, to make me a well-rounded clinician. And, my list looked like this:

  1. Orthopedics/Vestibular Rehab
  2. Orthopedics/Aquatic Therapy
  3. Orthopedics/Women’s Health

And guess which one I got? Yep, you got it. Orthopedics/Women’s Health. My third choice. I was assigned to a 5 month rotation in Shreveport, Louisiana, interning both at a Sports Medicine Clinic and a Women’s Health Clinic, with the most amazing and inspiring Darla Cathcart, PT, DPT, WCS (now a good friend, and always a great mentor).  And you could say, the rest is history.

I fell in love with the pelvic health population within the first few weeks. I remember one of the first patients I treated was a young woman suffering from severe pain with sexual intercourse. She had been experiencing this pain for more than 10 years, and had several relationships end by her inability to participate in sex. I remember the day she came in and tearfully told us that she had been able to have sex with no pain for the first time in her life. I get goosebumps even typing it. It was then, in that moment, that I knew, I just had to treat this population. 

So, from that moment forward, I was in. I spent all of my free time researching pelvic health problems. I attended 2 continuing education courses as a student. And that amazing neuro rotation I was looking forward to? I spent my days off observing with their pelvic floor specialists. I even did my inservice on management of constipation in adults after experiencing strokes. You see? I was 100% in. And I have been ever since.

So, why in the world would I want to be a pelvic health PT? 

  • Because close to 50% of women and 25% of men experience urinary incontinence in their lifetimes, and close to 90% have a difficult time telling their healthcare providers about it, and seeking treatment.
  • Because 10-15% of people experience chronic pelvic pain and have to see an average of 6 different healthcare providers before getting the help they so desperately need.
  • Because almost 1 in 5 women experience pain with sexual intercourse

These people need us. They need me. And honestly, I need them. I learn about perseverance as I help my patient who has had chronic pain for 10+ years work hard and fight to move forward toward a pain-free life. I learn about courage, as I see the strength in the young lady I am helping overcome pain with sexual intercourse as she decides to try again for the first time. I learn about bravery as I listen to my patient who has been struggling with leaking urine tell me about spending the day shopping without wearing a pad.

The truth is… my patients change me every day as much if not more than I hope I can help to change them. And that, my friends, is why I am thankful every day to be in this profession. That, is why I am a pelvic health physical therapist.

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One response to “Why I specialize in pelvic health

  1. Pingback: Your bladder and bowels need a diary. | Jessica Reale, PT, DPT, WCS

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