When the "best" treatment fails.

After being battered around by the medical community for a few years, I showed up on the doorstep of a wonderful pelvic physical therapy practice, Pelvic Therapy Specialists, in Boulder, Colorado.  Operated by the brilliant, kind, and dedicated Dr. Sandra Shevlin, I felt hopeful the moment I stepped through their doors.

The environment was cozy and reassuring.  The clinic was abuzz with competent, busy, friendly women.  At the time, there were three physical therapists (PTs) practicing there: Sandra, Krista, and Jerri.  I found myself in their waiting room after my gynecologist strongly insisted that they were worth the (out-of-state) trip.

My initial intake appointment was with Krista, a lovely and young PT.  She sat across from me and my husband and asked me question after question.  Most of them were questions that no one had asked before.  She obtained my first comprehensive history.  She reviewed basic concepts of pelvic floor structure that I'd not learned before.  And then, she examined me ever-so-gently.  

Initial visits with pelvic floor PTs have not, in my experience, been fun.  This one wasn't fun, but it didn't approach the level of nightmarish either, and I really liked Krista.  During her exam, Krista told me that she wasn't going to go around poking at vaginal trigger points.  Instead, she was going to gently insert one finger and just apply gentle pressure to tight muscles.  She did just that, and by handling me gently, she earned my trust.  It was painful, but not nearly as painful as having someone spastically poke at random internal tender spots.

The next day, I returned and saw Sandra, who owned the practice.  She spent some time working on my back, and then doing skin-rolling of my abdomen, thighs, and back.  She tried a dry needle, but after I nearly fainted, we abandoned that treatment approach.  I returned to my hotel that night pretty sore, but again -- things were happening.  I felt like this treatment should heal me.

This is how the rest of the week went, and on Friday afternoon, I checked out of my room at the Hyatt.  My husband and I dropped our rental car at the airport and flew home to Albuquerque.  I would return to that practice many more times for treatment with these wonderful women.

Ultimately, treatment at their practice did not heal me.  After so many physically, emotionally, and financially draining trips, a hard truth hit me.  This treatment, and these PTs, weren't going to be the ones to get me better. This was true despite how badly they wanted to help me and despite how compliant I had been with their treatments.  It was true despite how passionately they felt about pelvic floor disorders, how much book knowledge and certificates about my issues they possessed, and how personally involved with my case they felt.  These women genuinely, deeply cared for me.  I felt a great affinity for and closeness with them.  They'd become friends, confidantes, and people upon whom I depended heavily.  It was very, very difficult for me to accept that they weren't going to "get me better," and I think it was probably an equally difficult pill for them to swallow.

So, what was the problem?  In mulling this dilemma for the past four years, as I did recover under the care of Sandy Hilton (Entropy Physiotherapy & Wellness in Chicago), I have decided that one thing should guide healthcare above all others: No provider or treatment is right for every patient. Healthcare, especially the recovery from chronic and complex conditions, is an incredibly personal experience, and different people will heal in vastly different ways.

Healthcare isn't an objectively measurable thing, in many respects.  Is there a "right" treatment for pelvic nerve pain?  There was a right treatment for me, but the wonderful ladies in Boulder also provide the right treatment for the countless women they heal.  This concept is frustrating to me (and providers too, I'm sure), because it means that healing isn't very simple.  It's complex, requires introspection by providers and patients, and may be a journey through different treatment modalities, rather than a one-stop-shop fix at a clinic.

I have been contacted in recent years by some of the physical therapists from my past.  In seeing my posts about some of the horrible care I've received and of the amazing recovery I experienced with Sandy, they have expressed empathy, offered apologies, and made inquiries about what did work.  The thing is -- the work that the women at Pelvic Therapy Specialists are doing is amazing.  It does work for so many women.  And that is the key here: patients are unique, conditions are unique, and providers are unique.  It's not about finding the provider you like the best, the provider with the most degrees, or the provider who's practicing the latest and greatest treatment approach.  It's about finding the provider who can help you.

For me, that provider was Sandy Hilton.  But Sandy is part of my multidisciplinary team, who were also essential to my recovery, along with my husband, family, friends, and dog.  But that doesn't change my high opinion of many of the others who have treated me, and it doesn't mean that they didn't try their damnedest to help me improve.  

If you're in the Boulder/Denver area, check out the Pelvic Therapy Specialists website.
And if your'e in the Chicago area, check out Entropy Physiotherapy's website.

Happy healing, wherever you are.