3rd PT

We didn't do everything we'd planned to do. We started by going over my pain and leaks from the past two weeks. I'd had no leakage, good for me! Probably eight or nine days of the past two weeks have been completely pain free. I mean, completely. When I'm getting ready for bed at night, I do a little assessment. Five or six days, I realized that I had a tiny bit of pain, which was significantly less than before my second therapy session. The rest of the time, I couldn't feel any pain. That was the most exciting part of my assessment this morning. She said that the days I'm having a bit of pain is probably from my bones slipping out of alignment, though I am still doing the exercise to line them back up. And that's why it's important to keep doing the exercise.

She checked my alignment next. I had gone down the stairs, up the stairs, and down again between doing my alignment exercise this morning and the appointment. However, my pelvis was correctly aligned! My tailbone, on the other hand, was twisted. She gave me a second exercise to do, which went like this: I laid on my left side, with my left leg straight, right leg bent, and right shoulder back. It is a twisted position. Then, she put her right hand on my right shoulder, and her left arm sort of over/around my right hip. I pushed my right shoulder forward and my right hip back, held for six seconds, then repeated. At the end of that, my tailbone was straight. To do this on my own, I sit with my knees together, feet apart, and put a belt around my legs, right above my knees. Then I push my legs apart, against the restraint of the belt. This is being added to my pelvic alignment exercise.

Next, she wanted to check my muscles. Since I've had no problems with leakage and no trouble doing my kegels twice a day, she didn't think it was necessary to hook me up to the computer again. But she wanted to check the nerve endings that she checked at the first appointment to see if they are still sensitive. Remember, I had pain at six, seven, and eight o'clock (positions on my pelvic floor), and the number four nerve on the inside. She checked all of those. They are still a little tight, but she said I'm "almost normal." The number four nerve was uncomfortable when she tugged it, but not even close to painful. At the first appointment, it was the most painful.

And that was it. She said that I am well on my way to complete recovery. It's unusal for the majority of pain to be caused by the pelvic bones being misaligned, but it appears that mine definitely was. I have assignments to do my pelvic bone alignment and tailbone untwisting exercises twice a day for a while (at my discretion). I can drop the tailbone exercise when I feel like my pain is completely gone. Then, I can wean myself from the pelvic bone alignment. I should keep doing kegels twice a day, but can eventually drop to just before bed. And really, all women should do kegels once a day.

Then, she canceled my remaining appointment with her and asked if I wanted to cancel my appointment with the doctor. He wanted to see me again to make sure my muscle tone is good enough to be safe for a future vaginal delivery. But, I don't feel the need to see him again. If I happen to get pregnant again, we can assess my muscles at that time. Also, if my pain comes back or I have further concerns, I can do more therapy.

In conclusion, if you are experiencing pelvic floor pain or urine leakage many weeks after delivery, pelvic floor physical therapy can work wonders. I was skeptical that it could do much for me. I had 120 days of pain before my second therapy session. The 121st day was pain free. It was definitely worth it.

2nd PT

We started by going over my homework (the log of my drinks and restroom trips). She had no problems with it. She was curious as to why I was drinking so much, but when I explained that I was pumping milk for Kibuyu, she understood. I estimated how much I drink and go to the restroom now that he's all on formula, and she said it was very normal.

Then, she checked to see if my pelvis is misaligned. It commonly happens when a woman gives birth, since the bones have to separate to make way for the baby. They don't always return to the correct place. She first made sure that my legs line up straight, which they do. Then, she compared 3 points on the front by putting her thumbs on matching bones on each side and checking to see that they're even. I rolled over and she checked a few points on the back, too. She said that, compared with the right side, the left side is rotated towards the back. But, she couldn't tell by looking which one was right. So I stood up, she found a bone in my hip, and I raised my leg. We did that on each side so she could feel my pelvis while I raised my leg. She then concluded that the right side was good, but the left side was messed up.

To correct it, I laid down on the table again. She had me hold my right knee and hang my left leg off the table. I was to push my right knee into my hands, towards the wall at the foot of the table, while pushing my left knee straight up, into the therapist's hand. I held for six seconds, then rested. We did that three times, and she checked my bones again. I was straight then.

There are many things throughout the day (especially including walking up and down stairs) which can throw the alignment off again. For the next two weeks, I will do this exercise twice a day. Since I go down the stairs of our apartment and up the stairs at work every morning, and return every evening, I'll be doing the exercise when I arrive at work (on a table) and when I return home (on the bed). Since the therapist isn't here to hold my left knee, I hook my heel around the edge of the table or bed and push to the right, rather than up.

After realigning my pelvis, she stuck some sensors to my pelvic floor muscles, and plugged them in to her computer. They measure how tense the muscle is. Zero is completely relaxed, five and over is flexed. (I don't know what the units are...) When resting, the muscle should be under two.

When she turned on the program, my relaxed muscles were between three and five. While laying on my side, I flexed and held for as long as I could. It wasn't very long, but the bigger problem was that my "relaxed" muscles were not relaxed. We went through ten cycles of me flexing for ten seconds and relaxing for ten seconds. By the end, I was able to relax completely. Then, we went through ten cycles of me flexing for one second and relaxing for two seconds. In the beginning, two seconds wasn't long enough for me to relax. But by the end, again, I was able to relax my muscles. I will also do those two exercises twice a day for the next two weeks.

We did a test run of me doing the Kegels while sitting. It was worse than my first attempt. I was so tense. We were running out of time, though, so that will be what we work on at the next appointment. Sitting, then standing. Maybe after two weeks of doing them lying down, I'll have enough control to do it better sitting.

I don't know that it's been long enough for this to have any effect. Possibly if my pain was coming from my misaligned pelvis pulling on my muscles, aligning it would eliminate that pain. I don't remember if I had pain on Friday. But I do remember that when I went to bed last night, I had not experienced any pain all day. That was my first day with no pelvic floor pain since Kibuyu was born! He was four months old yesterday. I hope that eventually my pelvis will stay in place so that I don't have to keep realigning it every day. When next I see the therapist, I will go down the stairs at home but not have a chance to realign my pelvis before my appointment. We will see how crooked I am then.

The other thing on the schedule for my next appointment is working on the scar tissue. She hasn't told me yet what all that entails.