reply to Bev about PT
From: ZIMLICKI,PAULA M (MKT-PMZ@womans.com)
Wed Oct 25 12:02:50 2000
A note: I wrote this reply on Tuesday, October 24, 2000, before
Beverly put in the postings her fear that a "marketeer (sic) I fear we have
a marketeer looking for some business with a group of people in pain.." As I
said in a posting earlier today, I am not a marketer looking for business. I
am a fellow sufferer from adhesions who is only trying to pass along
information that helped me, and I hope will help you. I thought that was the
purpose of these postings. If anyone would like to talk to me or send me
email, please do so. I ask that you send to my home email of pmzim@msn.com.
Thank you.
Dear Beverly,
Thanks for your reply. I would be glad to answer all your questions. I want
to be sure to answer all your questions (they are all very good questions).
But, briefly, I have had three laparotomies for Stage IV endometriosis, two
laparoscopies, a hysterectomy/oophorectomy done through laparotomy at age
30, and another laparotomy for adhesions. I have suffered from abdominal
adhesions since 1987 and from pelvic pain since the age of 15 (I am now 47.)
I make my living as a medical writer who specializes in women's health
issues. I am a member of the American Medical Writers Association. I have
been a volunteer for the Endometriosis Association for 18 of the 20 years
the organization has been in existence. I am cofounder of the Boston Chapter
of the Endometriosis Association and ran its support/education group for six
years.
You are correct in that treatments need to be studied and confirmed through
scientific studies, and that using physical therapy for abdominal adhesion
treatment is not a well-known treatment. You are absolutely right in that
comments about treatments need to be substantiated. I hope this discussion
helps to do that. One way in which treatments that are considered
experimental finally become standard is through controlled studies. However,
to get to a controlled study, often it is the voices and experiences of
people who have suffered from a condition that get medical researchers to
consider other treatments. Just as not all medications help all people with
the same disease, just as surgery does not help all people with the same
disease, the same can be said for physical therapy.
When I used the word "soften" in my previous post, I was not using it as a
medical term, but as a means to describe how I feel my adhesions have become
through physical therapy, exercise, and Yoga. Believe me when I say I have
been through the medical mill and back with endometriosis, infertility, and
adhesions. I am a skeptic by nature, too.
Let me take your comments one by one.
Your comment: Adhesions are located deep within the abdomen and many
surround the
intestines, as time goes by the adhesion tissue toughens thus
constricts the
intestine or pulls other attached organs out of position more and
more, how
can PT help in that process?
How does a therepist massage adhesion on the bowel? What about in
the deep
abdomen? There ia the large thick rectus muscle as well as a layer
of fatty
tissue between the surface of the abdomen and the adhesions, how are
the
adhesions massaged?
What you describe above is exactly how my adhesions were. They had
constricted my bowel to the point that having a bowel movement was painful
and almost impossible. That is when I had my surgery. Things were fine for
awhile until the pain returned again. I did not want more abdominal surgery
as my abdomen already looked like a road map with multiple incisions, and
the risk of bowel and urethra damage were high. Desperate to avoid surgery,
I decided to try physical therapy. The way my PT massaged my adhesions was
by massaging the scars to which they were stuck. She did this manually
through a massage technique called "myofascial release" that stretches
specific tissues and scars, and through ultrasound. The physical therapist
also used heat on my abdomen before and after simple stretching movements to
help with pain.
In the beginning, I saw the physical therapist twice a week. Gradually,
exercises (not aerobic or anything that causes jolting movement) were
introduced into my program. These exercises involved very gentle movement,
and anything that caused pain was not included as part of the program.
Your comment: A TENS unit is a nerve stimulator, how would that be
of benefit on adhesion
tissue as there is no nerves in adhesion tissue? And where would a
TENS be
placed on a person for abdominal adhesions, as without a
laporoscopic
surgery, it is unknown where the adhesion are and what they are attached to?
While there may not be nerves in adhesion tissue, there are nerves in the
pelvis. The TENS unit did not "get rid" of my adhesions (nor did physical
therapy) but what the TENS unit did do is help me with the pain. Because I
had had laparoscopic surgery, I was fortunate in knowing where my adhesions
were located. You are right in that only through laparoscopy can abdominal
adhesions be diagnosed. My statements were meant as suggestions for people
in whom abdominal adhesions had been diagnosed. Since the physical therapist
could refer to my medical records in knowing the location of the adhesions,
she was able to place the TENS unit on my abdomen in optimal location to
help relieve pain from the nerves.
Also, let me emphasize, that all the treatment my physical therapist did
was done in conjunction with a physician's order, and regular updates were
given to my physician on my treatment and condition.
Your comment: Excersise that cause pulling of the organs that
adhesions are connected to
will increase inflamation thus pain, if a person cannot bend or sit
for long
due to the intestines not being able to move up and to the back of
that
person becasue they are attched to the peritoneum ( inner abdominal
wall )
wouldn't excersise create even more pain? At times even movement
while
riding in a car can cause pain simply from the motion of the moving vehicle.
You are absolutely correct that exercise can pull pelvic organs, thus
increasing pain. I did not say that all people with pelvic pain are
candidates for trying PT. What I did say is that PT might be a viable option
for some people to try, depending on where they are with treatment of
whatever disease process is causing their pain. My adhesions were attached
to my bowel, to the cul de sac of my pelvis, to the scars from previous
surgeries. Even movement in a car caused pain if that part of my body was
jolted. I benefited from the one adhelyosis I had had, but I still had
adhesions.
It had been years since I was able to do any type of exercise as most
movement caused pain. My body felt as though it had folded in on itself and
was becoming more and more inflexible and rigid as I tried to protect myself
from pain from the abdominal adhesions. Physical therapy helped me become
less rigid and more flexible.
Your question: Have you seen adhesion of the bowel or pelvis?
Yes, I have in my work as a medical writer, from observing surgery in the
OR, from attending certified medical education programs for health care
workers, and from researching the medical literature. I have published an
article on adhesions (1988) that appears in the book, The Endometriosis
Sourcebook.
Your comment: It is imarative that comments of this nature be substantiated
for those who
are desperatly looking for medical intervetion and it is also
important for
them not to pay money they do not have in treatments that will be
ineffective for this disease...it is my opinion that PT will not
help
adhesion sufferers other then to empty the pocket books. BUT...show
me
proof of all that was discribed here and I will be very willing to
research
it.
My ONLY goal here is to offer a possible option for those who have tried
other options that have not worked. I obviously disagree with your comment
about PT not helping abdominal adhesion sufferers other than emptying their
pocket books.
All of this treatment took time. Nothing about it was magical. I had to
commit to seeing a physical therapist twice a week in the beginning. After a
few months, my appointments were weekly, and then, every other week. I was
very fortunate to have insurance that covered most of the cost of this
treatment, which is expensive.
I am no longer in treatment. I continue to do my exercises, use TENS and
heat when I need it. Three months ago, I began taking a Yoga class, and that
has helped me. However, I would not have been able to take Yoga at the
beginning of my treatment because of the pain and inflexibility caused by
the adhesions.
Let me emphasize that I know what it is like to live with daily, unrelenting
pelvic pain. I know what it is like to not be able to do the things you want
and to not be able to exercise because any movement causes pain. I know the
hopelessness and anxiety that can be created when nothing seems to help the
pain. I know what it is like to be exploited in my efforts to find
treatments for my pain.
Yes, not much has been written in the medical literature on using physical
therapy to treat pain from adhesions. But, if a person has tried all else, I
firmly believe trying physical therapy as a viable option for abdominal
adhesions with a physician's order, as I did. I am living proof, and believe
me, I am as skeptical as anyone when it comes to treatments that aren't
supposed to work.
Paula M. Zimlicki
mkt-pmz@womans.com
> -----Original Message-----
> From: Bernie and Beverly Doucette [SMTP:bnb@cybrzn.com]
> Sent: Tuesday, October 24, 2000 2:30 PM
> To: Multiple recipients of list ADHESIONS
> Subject: Re: How do I prevent them from coming back?
>
> Please send substantiating information as to how PT can soften adhesion
> tissue?
>
> Adhesions are located deep within the abdomen and many surround the
> intestines, as time goes by the adhesion tissue toughens thus constricts
> the
> intestine or pulls other attached organs out of position more and more,
> how
> can PT help in that process?
> How does a therepist massage adhesion on the bowel? What about in the deep
> abdomen? There ia the large thick rectus muscle as well as a layer of
> fatty
> tissue between the surface of the abdomen and the adhesions, how are the
> adhesions massaged?
>
> A TENS unit is a nerve stimulator, how would that be of benefit on
> adhesion
> tissue as there is no nerves in adhesion tissue? And where would a TENS be
> placed on a person for abdominal adhesions, as without a laporoscopic
> surgery, it is unknown where the adhesion are and what they are attached
> to?
>
> Excersise that cause pulling of the organs that adhesions are connected to
> will increase inflamation thus pain, if a person cannot bend or sit for
> long
> due to the intestines not being able to move up and to the back of that
> person becasue they are attched to the peritoneum ( inner abdominal wall )
> wouldn't excersise create even more pain? At times even movement while
> riding in a car can cause pain simply from the motion of the moving
> vehicle.
>
> Are there brochures or information on these treatmenst? What has the
> history
> been as far as success? How is this success tracked if there is statistics
> on PT & Adhesion disease?
>
> Have you seen adhesion of the bowel or pelvis?
>
> It is imarative that comments of this nature be substantiated for those
> who
> are desperatly looking for medical intervetion and it is also important
> for
> them not to pay money they do not have in treatments that will be
> ineffective for this disease...it is my opinion that PT will not help
> adhesion sufferers other then to empty the pocket books. BUT...show me
> proof of all that was discribed here and I will be very willing to
> research
> it.
>
> Your new here, and we are happy that it worked for you, Paula, and who did
> your surgery? How many surgeries have you had and how may years have you
> suffered with adhesions? Did you have endo as well my dear? Thank-you for
> sharing this and we look forward to hearing more on this and answers to
> these questions as well.
>
> Sincerely yours
> Beverly
>> ----- Original Message -----
> From: ZIMLICKI,PAULA M <MKT-PMZ@womans.com>
> To: Multiple recipients of list ADHESIONS
> <adhesions@mail.medispecialty.com>
> Sent: Tuesday, October 24, 2000 12:10 PM
> Subject: RE: How do I prevent them from coming back?
>
> > I suffer from adhesions due to so much abdominal surgery. I had one
> surgery
> > for the adhesions, which I always found ironic since surgery is what
> caused
> > them in the first place! The second time the adhesions began giving me
> lots
> > of pain I tried physical therapy, and it worked. The pain was so severe
> that
> > it woke me up whenever I turned over at night. It's important to get a
> > physical therapist who has received specific training in abdominal
> > adhesions. The American Physical Therapy Association, which has a
> website,
> > can give you information as to whether a PT in your area is available. I
> > encourage all of you to try this. Through the use of ultrasound, scar
> > massage, heat, TENS unit, and exercises tailored toward the adhesions, I
> was
> > spared another abdominal surgery. The PT treatment does not get rid of
> the
> > adhesions but can soften them enough so that they don't cause the pain.
> It
> > spared me another abdominal surgery! I would be glad to answer any
> > questions.
> >
> > Paula M. Zimlicki
> >
> > mkt-pmz@womans.com
> >
> > > -----Original Message-----
> > > From: acinom@primenet.com [SMTP:acinom@primenet.com]
> > > Sent: Sunday, October 22, 2000 9:09 PM
> > > To: Multiple recipients of list ADHESIONS
> > > Subject: How do I prevent them from coming back?
> > >
> > > Hi everyone! I just stumbled upon this site tonight, I have yet to
> join
> > > the forum, but I was wondering if anyone could help me. I have endo,
> I
> > > had 2 laps in 99, and I have another one scheduled for October 30th.
> > > Each of the last times they found more problems with the surgical
> > > adhesions from an appendectomy back in 88 with minimal endo. The
> amount
> > > that came back in just 4 months was amazing. Well, the pain is back,
> > > and again I suspect it to be adhesions rather than endo, but who is to
> > > know for sure which is causing the pain since I have both problems? I
> > > dont want to take Lupron or any other hormonal treatment other than
> > > bcp's particularly because I fear the big problem is the adhsions so
> why
> > > mess with endo drugs if that isnt the issue? Anyway, my questions for
> > > you are these:
> > > Have any of you tried Acupuncture? Either to relieve pain or to keep
> > > adhesions from reforming (is this possible?)
> > > Is there anything I can do after this surgery to retard the growth of
> > > this stuff?
> > > Please email me at acinom@primenet.com if you can be of any
> assistance.
> > > I appreciate it more than you can imagine!
> > > I hope this finds you all pain free and blessed with love and laughter
> > > *HUGS*
> > > Monica
> > >
> > > to the unsubscribe form at
> http://www.adhesions.org/forums/listcmds.htm
> >
>
|
