7. What's My Pelvis Got to Do With It?

In this episode, Alex talks with Lesley Jones, a pelvic floor Physical Therapist with Southwest Florida Pelvic Health, and Lauren Samples, a former patient, about everything pelvic floor. From incontienence, to endometriosis, to penial dysfunction. The pelvic floor has everything to do with it! And we dive into what exactly a pelvic floor physical therapist does and how our pelvic floor is so interconnected with everything we do.

Pelvic Floor Therapy Resources:
swflpelvichealthclinic.com
American Physical Therapy Association | APTA
pelvic Archives - Pelvic Global
Find a Pelvic Rehabilitation Practitioner Near You

Connect with Lesley and Lauren on Instagram:
Lesley Jones @belowthebeltphysio and @swflpelvichealth
Lauren Samples @laurensamples_fla and @flordiathemisproject

Find It's Sensitive on Social Media:
https://linktr.ee/itssensitive
@its_sensitive_podcast

Episode Transcript

(00:12):
Hey, everyone, it's Alex fromIt's Sensitive. Today. I have Leslie,
who's a pelvic floor physical therapist inNaples, Florida, and also joining
me is double trouble with Lauren,who is a fellow podcaster and friend of
mine who happens to be a formerpatient of Leslie and suffers from pelvic floor
dysfunction. I'm so excited to haveboth of these ladies join me today to

(00:35):
normalize the conversation around pelvic floor health. Well, good afternoon, Leslie and
Lauren. How's it going? Hi, Nune, thank you for having me
us. I should say I amso happy to have you. First of
all, I appreciate you joining mefrom Florida. So Ohio Owens. This

(00:59):
morning had a wonderful tornado siren wakeus up at five am, and we
had a couple of scary touchdowns,so we role reversed and instead of me
coming to Florida for disaster response,we were part of the disaster today.
Oh wow, Yeah, everything's allday, yes, thankfully for me,
and so far i've heard we haven'thad any major injuries, but there was

(01:22):
definitely some damage done, so definitelymy thoughts are going out to those affected.
By the storms today for sure.So, Leslie, would you like
to tell us a little bit aboutyour background and how you got into public
floor physical therapy. I know that'sa pretty interesting field. So yeah,
I am Leslie Jones. I amoriginally from Canada, and public floor health

(01:47):
is very big up there. It'spretty big in the northeast of the US,
but still needs a little work,I find so in Canada kind of
the UK Australia, as all,you know, public floor physical therapy is
more widely known and accepted. I'vebeen a pet for seventeen years. I've

(02:08):
been in you know, orthopedics formost of it. Well, public physical
therapy is still considered orthopedics. Wejust consider it in a cave and that
is coined by one of my instructorsfrom Canada. Her name is Carolyn Van
Dyke and who I will always usethat term and always give her the credit

(02:29):
for it because it's a good one. So I got into public floor physical
therapy honestly after the birth of myfirst child. So things were not the
same, and things were not asthey should be, and in order to
have more children, I thought,oh boy, I better I better work
at fixing this or figure out what'sgoing on here. So I started taking

(02:51):
the courses and I just fell inlove with it and just saw a real
need for it and was really reallyexcited about getting to it. That's awesome,
Leslie, I am giggling so muchover here about orthopedics in a cave.
I'm glad you shared that term.And then, Lauren, did you
want to share a little bit aboutyour background before we get into some deeper

(03:14):
conversation, just so our audience hasa tidbit about you? Okay, Well
as a lot a lot of peoplemaybe recognize my voice. I'm Lauren,
one half of Paradise after Dark DarkDark Dark Dark Dark podcast, and I
also happened to have had pelvic floordysfunction for the majority of my adult life.

(03:39):
I started having PUBLC issues just likeLeslie after my first child, and
it took I actually looked it uptoday, and it did take me about
twelve years of being bounced around todifferent doctors and a couple a couple exploratory

(04:00):
surgeries which are called endo laposcopic laparoscopicprocedures, and only to be diagnosed twelve
years later with endometriosis. And Iended up having a almost full hysterectomy in

(04:24):
twenty seventeen. I honestly like that'sa that's a lot, Lauren, Like,
that's a lot to go through,and I'd imagine that's very difficult to
like piece together. Like I've haddifficulty like piecing together even my joint surgeries,
because it's just like you go afterone thing and another and another,
like it just kind of lends together. So yeah, well yeah, basically,

(04:50):
I just I've had problems for prettyserious problems for about fifteen years.
The last five years or so havebeen all right, And I'm glad to
hear that, Yeah, I'm doingI'm doing much better. And I met
Leslie along the way and she's wonderful. Thank you, Lauren. That's awesome,

(05:15):
And thank you both ladies for sharing. This is definitely a sensitive topic,
I know for a lot of people. So my experience, ironically,
as I have pelvic for health historyfor very different reasons than both of you,
is because I've had incontinence issues,which is for those of you that
may not know, is problems withholding my bladder, and so I've been

(05:38):
through pelvic for physical therapy for theincontinence and actually pain during sex as well.
Totally didn't realize that pain during sexdoes not have to happen. And
I've noticed during several conversations that Ihave with people that they have no clue
what pelvic for physical therapy is orthat it's even a thing that you can

(06:00):
treat. And I remember I wasin a Facebook group and someone anonymously posted
about pain during sex and I hadmentioned pelvic floor physical therapy and they are
like, I had no clue.I'm going to go immediately talk to my
obgyn. So from that perspective,you know, it's a little bit different
but the same. And Leslie,I'm sure you can attest to this a

(06:23):
little bit, maybe share a littlebit more about what pelvic floor physical therapy
does or addresses, and kind ofyour experience in that if you are comfortable
doing so. Yes, of course, we treat so many things it's hard
to know where to start, soI'm just going to kind of rhyme off
a whole bunch of things. Butabsolutely, incontinence, there's a few different

(06:45):
types of incontinence. There's stress incontinence, which is like a laugh, cough,
sneeze that's a downward force on thepelvic floor, and that causes some
urinary leakage. There's urgent continence whereit's like urgency, you get this big,
overwhelming urge to go. We kindof call it the key in the
door phenomenon. You get home,you just got home, you're trying to
get your key in the door,and you're like, oh my god,

(07:06):
I gotta go right now, andyou'll leak. And that is a completely
different type of incontinence than stress andcontinents. There's mixed you could have both.
There's overfull incontinents like you're retaining toomuch in your bladder, like you're
not getting the sensation to go,and there's two full and none you're leak.
And there's also fecal incontinents. Sowe treat all of those as well

(07:29):
as a whole host of pelvic painconditions. And like Lauren who has endometriosis,
which is where there's some endometrial liketissue growing outside of the uterus throughout
the abdominal cavity could be you know, anywhere from your diaphragm down to behind
to the rectum, and it's debilitating. It can be very debilitating for a

(07:53):
lot of people. It can causea lot of different symptoms of doominal pain,
pelvic pain, constipation, diarrhea,bloating, it is. It can
be very, very debilitating. Sowe treat that things like bladder pain syndrome
or interstitial cystitis or bladder both blackerpain conditions, and the terms are interchangeably

(08:15):
used at times. I also treatsomething called volvidinia, which is your volva
is actually the external portion of yourgenitalia. So it's like the labia,
the mons, all of that.Everyone calls a vagina like that's no,
that's inside inside is the kind outsideis the volva. So volvidinia is you

(08:37):
know, pain there and the externalvulva. And you know, sitting is
very different for patients wearing tight cloathingunderwear, things like that, any contact
there is very painful. There's also, you know, just like you had
said, painful intercourse. We callthat dysperunia. And that can happen for
many reasons. It can happen,you know, postpartum, and there's hormone

(09:00):
changes, tearing, you know,scar tissue forming, it could be you
know, anxiety and stress. Wehold a lot of tension in our pelvis
without even realizing that the pelvic flooris hosting all of this tension, and
you know, if intercourse has beenpainful previously, the next time you're going
to encounter that, you're automatically thinking, oh god, this is going to

(09:22):
hurt, and then you instinctively tighteningyou don't even realize it, so and
then it's going to be, youknow, painful again. So we treat
that dysprhnia as well. Vaginismus issomething where you know, the pelvic floor
is so tight that the actual openingto the vagina is closed. And so
yeah, patients like that. Ihave so many, honestly, and they're

(09:46):
just so lovely and they do sowell, and it takes a little bit
of time, but you know theycan then again be able to have you
know, pain free intercourse, anda lot of them have never had intercourse
because you know, the opening islike totally closed. So those are very
rewarding patients to work with. We'llsee, you know, patients that have

(10:09):
had cancer, any any female cancersand male cancers like prostate cancer, and
they've had the pastectomy and they're veryincontinent in rectil dysfunction, and you know,
we work with them for that.So I'm trying to think if I've
hit most things. But yes,that work as well because constant pation,

(10:31):
diarrhea, all of that goes alongwith it. So it's a lot more
than people think then. And whatwe've mentioned the other day when we were
speaking is even patients with low backpain or hip pain, if they've been
doing conventional pt or therapy for along time and not seeing any results,
they should be sent to a peltfloor physical therapist because we're going to look

(10:52):
at things, you know, alot differently from a different angle too,
and sometimes you can hit you know, some of the muscles internally with a
good trigger point, and that isgoing to help with their back and their
hip pain. Absolutely, Leslie.I appreciate you sharing that because I was
over here like giggling a little bitbecause I did not even realize there were
just so many different ways that thepelvic flour can interact with her body.

(11:16):
And I know Lauren was shaking herhead here a couple of times when Leslie
was chiming off on a couple dysfunctionsand issues. I'm sure, Lauren you've
had some experience with a few ofthese, haven't you. I have,
Yes, Yes, I have.Yeah, there's a lot you know,
some therapists may just focus on oneaspect of pelvic floor therapy, but I

(11:41):
like to make I like to knowas much as I possibly can about this
area just to help and treat asmany patients as possible. Yeah, you
know, I like that you broughtup the key in the door incontinence,
because I'm going to be super embarrassingto desensitize this. I am a grown

(12:03):
adult. I'm in my thirties,and there have been a couple of times
where I'm on my way home inmy car, like I cannot hold my
bladder and I just went to therestroom before i had left somewhere, and
I'm doing the potty dance to thepoint like I've accidentally like urinated in my
car, and I'm like, I'ma grown adult, like why is this
happening? And it was polvic floortherapy that made me feel a little bit

(12:26):
like, oh okay, like thisis not just because like I can't control
it, Like my muscles, likeyou said, are tight down there,
and that was like a mixture ofthat incontinence and also why you know,
intercourse penetrate penetrative sex was you know, uncomfortable for me. Is my muscles
were just tightening up all the time. And then on top of that,

(12:48):
I was not strengthening the right musclesto help my bladder when it needed needed
some help, and I'd have togo to the bathroom. All my friends
who know me say, I goto the bathroom a million times a day.
And it got slightly better with publicfloor therapy, but the definitely,
you know, some other things gotbetter to with that, like the intercourse
and such, but it's embarrassing asan adult, like accident, having an

(13:13):
accident, and you know, youdon't want to talk about it with anybody.
And I think that's what makes itdifficult with pelvic floor therapy is there's
just so many things that are hardto talk about when it when it comes
to this, and especially as anadult, like I don't think you know,
it's hard to admit some of thosethings, right, And that's one
thing like we as public floor physicaltherapist, we don't want you to feel

(13:35):
embarrassed about this kind of stuff.You know, I know you're saying,
you know, you're an adult inyour thirties and this is happening and it's
embarrassing to talk about. But forus, this is our normal day to
chat. Like, you know,I am talking about bowel movements. I
want to know the shape and thecolor and the consistency and all that stuff.
So we I don't want you toever feel embarrassed about, you know,

(13:58):
talking about something like that, becausethe whole point of doing this is
to try and normalize, right seeinga public floor physical therapist or getting help
if you think you need it forsomething, So don't be embarrassed. I've
done it too, So it's okay. Thank you for making me feel better.
Thankfully had leather seats, so cleaningit was a little bit easier here.

(14:20):
Yeah. So Lauren, I feellike you maybe have a few things
to throw in here with all thegiggles you've been having as well. Well,
I just I'm relating to almost everythingI've okay, So just to just
to preface this, I met Leslie. As I mentioned in the beginning,

(14:43):
I had endometriosis. But the reasonI met Leslie, the reason I started
to go seek out physical public floorphysical therapy, was because I was having
pain in my tailbone, which wasso weird to me. I was like,
what the heck is going on withmy tailbone? I couldn't sit I
ended up having to sit on likea doughnut pillow for a while, and

(15:09):
I could not figure out what waswrong. I had X rays done,
you know, and uh, finallyI met Leslie, and I think it
was in the first or second session. She's like, yeah, no,
your muscles are just so tight andtraumatized because I had had several laparos lap

(15:31):
laparoska piece. Please edit me,don't worry. I got you. Yeah,
I can't edit. I can't editout every single Yes, you can
go stiff term from the podcast.You're good, Leslie, correct, You're
all right, Thank you. I'vehad many laparoscapis, and when I say

(15:56):
many, I mean like between twothousand and nine and two thousand and twenty.
Yeah, twenty twenty. It's elevenyears I had. I think I
believe it was six abdominal surgeries,one of which one of which was a

(16:18):
partial hysterectomy and almost full hyster directedme. They took everything except for a
portion of one of my ovaries,and the only reason they left that was
so that I wouldn't go into fullblown menopause immediately. And anyway, back
to my tailbone. Turns out thatbecause of the trauma that my pelvic floor

(16:41):
had endured during all of those probablylooking back, unnecessary surgeries. My muscles
were traumatized and they were tight,they were so tight, and I was
dealing with painful intercourse. I wasdealing with, you know, cramping in
even like lower back pain, andthis this gosh darn pelvic or not pelvic,

(17:04):
I'm sorry, tailbone pain of allthings. And then come to find
out it's because of my pelvic floor. You know, I know that,
I know that those areas are similar, they're close together, but I just,
yeah, that's one condition I forgotto mention that we treat. Yes,
says coccidinia is a medical term,but yeah, tailbone pain so many

(17:30):
Your pelvic floor is a whole hammockof muscles that it's a diamond shaped hammock
that goes like from your symphysis pubisat the front of your pelvis to your
tailbone and from your two sipbones atthe sides. It's this big hammock of
muscles and a lot of them attachedto the tailbone itself. And if they're
too tight, you know, ortight on one side more than the other,

(17:52):
they can tug and pull on thetailbone, you know, and cause
pain, and them just being tightcan cause pain, and it can refer
pain places even like the low backwhere you're like, what the heck is
going on? So that was thatwas what was the first thing that I
saw Lauren for. Yes, Ithink I saw you for a couple of
things. Yeah, yees. Goingback to Leslie for everything. The tailbone

(18:19):
is tricky. I was just havingthis conversation with the patient today. The
actual tailbone being a source of pain, like there's a problem with the tailbone
is actually pretty rare. It's usuallythat pain is stemming from somewhere else.
It could even be stemming from yourthraco lumbar junction and your spine has a
referral pattern to the tailbone, yourmuscles attaching around it. If you know

(18:42):
they're too tight, they can becausing you know, pulling action there and
painful to the tailbone. It canbe a lot of different things, you
know, causing pain. Was sittingand it feels like you feel like your
tailbone is broken, but it's not. So that was what Lauren's case was
with this, and she did shedid very well with therapy, so we

(19:04):
do. That's the other thing wedo do you know, vaginal exams,
and can hit most of the publicfloor muscles that way, but also rectally,
there's a few other muscles that wecan hit as well. We can
hit a lot of the same ones, but then there's specific ones that we
really do need to check as wellas we can assess the tailbone in rectally,

(19:25):
so you know, it's it soundsscary, but we're so slow and
so gentle, and you know,I have teeny tiny fingers, you know,
So it's not like you know,other doctors you'll go to and it's
like, Okay, bend over andyou know, up you go. It's
it's it's not like that at all. It's a lot it's a lot slower

(19:45):
and a lot more gentle, andhopefully Lauren will graves me yes, I
can say, uh, my firsttime going to physical therapy. I have
really had absolutely no idea what toexpect, no clue. I'm thinking,
literally I'm driving there and I'm like, am I going to be doing some
kind of weird exercises on some kindof machine? What is this? I

(20:10):
had no clue what helvic floor physicaltherapy was. So I get there and
I meet Leslie she's very very ImmediatelyI liked her, you know, she's
just so open and easy to talkto, and I she she I don't
feel like I even still really understoodafter the first appointment what was coming down

(20:33):
the line. She had made acouple comments and I'm thinking about, you
know, checking things vaginally and anally. But she made she made sure that
I knew that we did not haveto do that immediately. We could wait
until we were ready. But Idon't think it sunk into me until like
maybe the next time I came back. I'm like, wait a minute,

(20:57):
I'm just gonna be very blunt herebecause this was my thought. Wait a
minute, somebody's gonna be like stickingin their fingers inside me. That's that's
a little intrusive. I mean,that was my thought. But after a
few so so it didn't start outlike that at first. Leslie did a

(21:18):
lot of outside work. Even Iremember she was doing hitting pressure points,
like on the inside of my thighs, on portions of my back, on
my belly. She was doing aroll it because I had a lot of
scar tissue and she was rolling thatout. She taught me how to do

(21:40):
that myself, you know, justto break that up, break up the
scar tissue. We did a lotof outside work, and I think maybe
it might have been on our likefourth session that I was like comfortable and
I was like, all right,you know, let's try this. And
honestly i've I didn't. Maybe it'sLeslie, maybe it's how they're taught,

(22:03):
maybe you know, I don't knowwhat it was, but I was just
a felt one hundred percent comfortable andconfident and trusting and was able to definitely
improve with you know, the treatment. The all of the treatment definitely improved
my tailbone pain. And then lateron I had come back for a couple

(22:30):
other issues. I think, likegeneral I had some general pelvic pain for
a while that Leslie helped me with. And most recently I was having not
incontinence, but extreme urgency that Iwas nervous was going to turn into incontinence,

(22:51):
okay, And it turned out Iwas just apparently drinking too much water.
That's that's what Leslie told me.You raarity, Normally, I'm fighting,
you know, to get patients tobe more hydrated. Everyone thinks if

(23:11):
you drink less water, you'll leakless. That is not true, and
it's actually the opposite. When yoururine is really concentrated, it's a big
irritant to your bladder. And wecan talk more about bladder irritants. But
when your urine is really concentrated,when you're really dehydrated, you actually will
leak more because your bladder is soirritated by this concentrated urine that it'll spasm

(23:32):
to try and get rid of thaturine. When you're more hydrated, properly
hydrated, you actually leak less.However, in Lauren's case, I'm not
sure how you're getting this much whileyou're drinking one hundred and sixty ounces one
hundred and eighty ounces, I don'tknow. I had that cup, that
large cup. Oh god, itwas time. No, no, no,

(23:53):
it had like it had like byeight am. I had to drink
this amount and then teda, Iam nude. It was like it was
like this under and twenty ounces orwhatever. Your I don't understand. I
still understand American terms with gallon,half gallon whatever. On's again, I
was drinking like two of those aday, and apparently that's too much.

(24:15):
So if that was one hundred andtwenty ounces or one hundred and twenty eight
ounces whatever and you were drinking twoof those it was like two hundred and
eighty something ounces. Like your yourpoor kidneys and your bladder filtering so much
every day, no wonder you werehaving. Just like to point out that
I am drinking a large cup ofwater right now as we're recording this.

(24:37):
Well, it's important to stay hydrated, but you know there's times where you
can drink too much water. Sobut that's la is that cup anymore?
Oh? Okay? Good? Andthis has when you're talking to from your
friendly local doctor. Yeah, soyeah. One thing I wanted to mention

(25:00):
I I don't typically get to aninternal exam on the first day. I
think it's important to explain everything,educate patients, make sure they're comfortable with
you. A lot of my patientshave been through some form of trauma in
their life, so the last thingI want to do is, you know,

(25:21):
have them do something that they're trulynot comfortable with yet I want them
to think about it, wrap theirhead around it, understand what I'm talking
about. A lot of therapists whoI love and respect are like, no,
first day number one, boom,we're doing this. I would rather
spend more time listening and educating andyou know, and then make sure that
they're comfortable with an internal exam.So and you know, what I say

(25:42):
to all my patients is we haveto go external to internal. There's no
point in jumping to an internal examand we haven't seen what everything else externally
is doing. So we look ateverything from your ribcage to knees front and
back is all related to what ishappening with the public floor. So this
is like the spiel I tell allmy patients, like, your diaphragm works

(26:04):
in unison with your pelvic floor likea piston. So if we're not breathing
properly, our pelvic floor never getsto relax and contract as it should with
every breath. So you know,I talk a lot about breathing and why
that's important. And then you know, we look at all the abdominal muscles
that come down and attach all thepelvic brim. You know, there's you

(26:26):
have a lot of hiplexer muscles,there's sous, there's iliacus, there's your
lower rectus. Abdominants that are allif they're too tight, they're going to
be putting more pressure, you know, on the pelvic floor and the bladder
and organs that you know can becontributing to their pain. And in Lauren's
case with the scar tissue and themultiple excision surgeries, you know, every

(26:47):
surgery we heal by forming scar tissue, so it's not elastic and like our
regular tissues, and it gets itsown pain, nerve innervation, and it
loves to stick and adhere to thingsthat it should not. So I do
a lot of connective tissue fashion work. I do visceral manipulation, where we're
literally making sure that everything is movingthe way that it should be and things

(27:10):
aren't too tight and impeding you know, function and also causing pain. So
we look at that and like shesaid, her inner thighs they have referral
paint patterns that can go straight upinto the pelvic floor, so I always
want to check those and make surethat they're not the source of some pain.
And then yeah, we'll look atlumbar and all your glute muscles,

(27:30):
hamstrings, everything, because they canbe contributing to the pelvic floor pain.
So I, you know, there'sa lot to start with externally before we
jump to anything internally. But that'sjust how I like to practice and again
not knocking any therapist that does aninternal exam on the first day, but
I find, you know, it'sI like to gain trust and explain and

(27:52):
you know, have them wrapped theirhead around it a little bit. Yeah,
a couple of things came up whenyou were talking. First of all,
it astonishes me. I've been inphysical therapy for a lot of different
joint issues a lot, and everytime I talk to any type of physical
therapist, I'm always astonished with howinterconnected our bodies are. And something that
kind of jumped out to me therewas that breathing works with the pelvic floor,

(28:17):
and it made me think about howwhen I run, how sometimes I
feel better if I'm doing breathing exerciseswhile I'm running and focusing on that as
opposed to just running. And sometimeswhen I'm shallow breathing, I just am
sore all over, and similar withthe knees and you know, the glutes
and stuff like that. I wasjust telling my knee physical therapists today that

(28:40):
my lower back was hurting because Ichanged my gait. But that's all related
to the pelvic floor and hip area, and I think it's important to note,
like with what you were saying,there is sometimes all is not what
it seems right, And I thinkthat kind of calls back to what Lauren
was saying in the beginning, isyou went, Lauren through a ton of
different I don't want to say exploratory, but like not helpful surgeries to come

(29:06):
down to a root cause that wasendometriosis. And I think it's important that
we touch on that a little bitbecause I'm hearing the term endometriosis a lot,
but oftentimes I hear that people aregoing through a whole lot more other
stuff before they realize it's endometriosis.And so I did want to kind of
touch on that specific condition a littlebit more. And Lauren, if you're

(29:29):
willing to share a little bit aboutthat condition, just what are some of
the challenges there and Leslie from yourperspective kind of what we're running into with
specifically endometriosis. Diagnosis is hearing itmore and more is becoming more common,
But based on our conversations, Idon't think it's more common. I think
it's just being more dignosed properly,right, Yeah, it is. It's
actually extremely common. One in ninewomen, one in nine muterus owners will

(29:56):
have endometriosis. It is actually verycommon. It just takes an average of
eight to ten years to get aproper diagnosis, so it's really a long
time. It's very unfortunate to suffer, you know, for that length of
time before you we know even whatwe're dealing with and to treat it properly.
Yeah. Yeah, And as faras diagnosis goes, I think the

(30:22):
reason why it takes so long,I think I've mentioned in the beginning that
for me, when I went backand actually looked at my records and whatnot,
it did take me twelve years toget the firm diagnosis. But you
know, Leslie, you had sentme something the other day about medical gas
lighting, and that is something Ione hundred percent experienced with several different doctors

(30:48):
where you're you're not believed. Somy mother was a nurse in the operating
room for about twenty years, dida lot of She stood in and helped
with a lot of gynecological OBGYN surgeries, and the doctors used to call them

(31:10):
whiny guynes, which she was aterm for women who complained about pain.
And this is back I'm saying inthe nineties, early two thousands and It
was two thousand and nine that Ihad my first exploratory surgery due to pelvic
pain, and they said it wasjust assist they got it rid of it,

(31:34):
and they said I was good togo. Then a year or so
later, not even a year,it happened again. I think I had
another. My next one was intwenty thirteen, and then it became an
annual thing until about twenty twenty.I called it my annual clean out.

(31:56):
But it wasn't until I met andI'm going to put the name out there
because I mean, he helped mequite a bit. His name is doctor
Joseph Gotta in the Florida Bladder Institutein Naples, Florida, and he was
the first doctor that actually looked mein the eye and said I believe you.

(32:19):
And that was I think I mayhave even teared up because after so
many years of being told, oh, it's in your head, or have
you thought about changing your diet,you might want to lose some weight,
or you know, it's just periodcramps, it's you know, get a

(32:40):
hating pad. Medical gas lighting islike the perfect term for it. And
I can almost get emotional right nowtalking about all that I went through and
even after getting the diagnosis with doctorGouda that we were still in the age
and this was literally less than tenyears ago. We were still in the

(33:02):
age where they were saying that ahysterectomy was a cure. Now looking back,
not a cure. Now we've learnedthat is absolutely not a cure.
And now I don't have a uterus. I don't have Filippian tubes. I

(33:23):
only have one tiny piece of uterus, which I think has pretty much dried
up and died. And I amforty years old and I have gone through
one hundred percent through menopause out theother side, So now I have a
whole slew of other hormonal things,vaginal atrophy. You know, there's a

(33:46):
there's a lot more to it,and it's just a wild, hard,
hard ride, hard road to godown. And I wouldn't wish this disease
on anyone. You're not even myworst enemy, honestly, it's it consumes
your life, and yeah, it'sit's pretty brutal. I appreciate you sharing,

(34:13):
Lauren, because I can feel thatpain, like that emotional pain you're
going through right now. I couldn'teven imagine the physical pain you had to
go through. And the scary partI think for me is you are not
the first person to tell me thatyou've been through so much, and you
know, it's it's hard to imaginehow many people are just suffering and waiting

(34:37):
so long to get help or diethe deproper diagnosis. And I appreciate you
sharing that because there could be somebodyout there going through the exact same symptoms
right now and have no clue thatit could be something like endometriosis. And
I think that's why this is agreat topic for us to touch on and
talk about and normalize, because themore we talk about it, the more

(34:58):
likely it is somebody's going to notice, Oh, that sounds a whole lot
like something I'm suffering from, oryou know, for Leslie, you know,
having someone referred to you to hopeout with that, you know.
And Lauren, I think you hada few more words to add on there
well. And and the symptoms forendometriosis can actually mimic a lot of other

(35:22):
things. I mean, menstrual cramps, lower back pain, pelvic pain,
pain during sex, in, diarrhea, constipation, what else. No,
I'm losing it, No, areyou loading? But You've got a lot

(35:43):
of them. The thing that issuch a misconception is, you know,
bad period cramps and back pain isnormal. It's it's not normal. It
should not be normal. So butbecause it's been normalized, you know,
in our society, it's like,oh, you just oh, she has
got her period. You know,she's in pain whatever. It should not
be debilitating. The thing that wealways look for when when if there's things

(36:07):
that patients will save me, andI'll cue them with questions and I immediately
will be like, they sound likethey could have endometriosis. It's usually very
heavy, painful periods where you mightmiss a day or two of school or
work, you know, because it'sso debilitating, painful intercourse, you know,
gut health stuff like constipation, diarrhea, all those ding ding ding,

(36:29):
you should be thinking endometriosis. Butlike Lauren was saying, that all seems
very normal you know in our society, but it is not. So you
know, anytime someone comes in andwe start talking about their cycle, and
you know, they start saying howheavy it is and how it's you know,
debilitating, and they have a routinethat they've got to jump on really

(36:51):
quickly, just to manage their painto not miss work, and I'm like,
hmm, okay, how's intercourse,And then you know, you ask
all those questions and you like Okay. Then I started thinking, you know
that it very well could be endometriosis. Yeah. Yeah, I think that's
a good call out, Leslie,because I think that's where having more conversations,

(37:13):
even with your healthcare providers about thatand the debility dictating pain like to
me, just resonates in the periodcramps, because I unfortunately, even in
the highest of offices in the UnitedStates, we've heard jokes about, well,
we can never have a woman presidentbecause she'll have periods and she'll get
cranky and she'll do this, andyeah, it doesn't matter where we've been,

(37:36):
we've all heard that stereotype, right, and they should just put me
in there because I don't have periods. Lauren for president. I'm running for
office. I'm running Lauren twenty twentyfour. Anyway. You know another thing
I really kind of wanted to touchon that affected me personally as far as
endometriosis was before my official diagnosis,my husband and I tried. We didn't

(38:07):
we didn't actively try. It wasone of those things like let's just have
a bunch of sex and see ifthis can happen. And I knew after
about a year, I knew somethingwas definite. I mean, I already
knew something was wrong because I wasalready having problems at the time. But

(38:30):
that's something that this disease has takenfrom me that I want to say,
is one of the more emotional things. One of the the pain, the
surgeries. You know, that's over, that's healed. For the most part.
I don't. I'm not in chronicpain anymore. But you know,

(38:54):
I feel like if if I hadbeen diagnosed earlier, or you know,
if there was some sort of cure, or if I hadn't been you know,
called a whiny guiny or treated likea drug seeker when I was trying
to get help, maybe I couldhave had more children. Maybe you know,

(39:16):
my life would be completely different.I mean, this type of thing,
it's not just a something that thatyou have and then you get rid
of this. This is a disease. Is it considered a disease disorder?
Disease? Yeah, I mean thisreally can affect your entire life, your

(39:37):
future, like your plans, allaspects, and you know, like I
used to go to a fitness bootcamp three times a week. I saw
a personal trainer once a week.I ran obstacle races like the Savagery of
his bart and Race, and Imean that was kind of my thing for

(39:59):
a long time. I was insuch amazing shape and then everything just went
to shit. It felt like atone time everything just went to shit.
I ended up having like three surgeriesin three years. I gained a lot
of weight. And it's real quick, Lauren, this was during or after

(40:22):
your hysterectomy removal, or you're sorry, it was before my actual hysterectomy.
Okay, I had had a couplelaparoscopy surgeries, but those are not too
bad. They're relatively easy to bounceback from. It's they they make two
to three very very small incisions,and then they stick a camera inside of

(40:46):
you and they do it all veryI don't know, not with the remote.
But it's not invasive. It's notinvasive, it but it is it.
It's not invasive, and then they'renot making a big decision. But
you have to remember they are stillrooting around there searching for the endometriosis.

(41:07):
You know, throughout your entire abdomen, so right, but hysterectomy is definitely
invasive. And since then, Iwas told by my doctor that I really
should not do any type of squatactivities, even lunging to a certain extent.

(41:30):
I see Leslie shaking her head.I'm just telling you what the doctor
told me. I know, I'mjust gonna I'm going to pipe in in
a minute and above that. ButI was told that now that my uterus
is gone, I'm at much higherrisk for bladder prolapse. So I need
to avoid putting a lot of pressureon my pelvic floor, which is what

(41:51):
you do when you're like weightlifting orsquatting or I mean, there's so many
And like I said, I wentto fitness boot camp, I saw a
personal trainer. I was in thebest shape of my life, and I
can't even do squats. So yeah, and I know, I know why
he was saying that, and Ido agree to a certain extent. Your

(42:14):
uterus is encased in what's called thebroad ligament. It's a really big broad
ligament, and it's a very stiff, supportive structure for the bladder that sits,
you know, kind of on topof it. When you take out
the uterus, that ligament structure isgone, so then there's not that ligamentous
you know, support for the bladderunder that. However, that doesn't mean

(42:37):
you can never squat again. Thatdoesn't mean you can never do a lunge
again. My goodness, Like theseare normal daily activities that we need to
be able to do just to functionin life. Like you know, you've
got to be able to bend overand pick things up. But there's a
timeframe, like you know, inthe first six to twelve weeks after hysterectomy,

(42:57):
No, I would not be jumpingback into boot camp, and I
would work with you on safe waysto get back into it, and you
know, making sure that everything isstrong and you're not pushing downward like you
know inter abdominal force downward, tobe pushing downward on your pelvic floor,
in your pelvic organs, so thatyou're not going to prolapse. He's not
incorrect. Yes, you are ata higher risk for prolapse, but if

(43:22):
you can still do things safely inorder to exercise and run and work out
and all that, and I don'twant you to be nervous about that in
the future. And that's something thatyou and I talk about another time.
Okay, you know, I wantedto touch on that what I was talking
about in the beginning there, aboutfertility, about you know, one in

(43:42):
nine uterus owners have endometriosis, andabout thirty five to forty percent of those
have fertility issues due to the endometriosis. So it is not every person,
but it is you know, afair large amount of patients that will have
some fertility issues, yes, whichis difficult, and said, yeah,
I was good. Thank you forLeslie for bringing that up because I was

(44:05):
going to touch on that. Lauren, First of all, thank you so
much for sharing that incredibly difficult experienceand journey that you've been through, because
not only did you touch on likehaving your body essentially ripped open in many
different ways as Leslie iterated there,but also you know, losing you not

(44:27):
only lost what you feel like isthe ability to be physically active and do
things that you enjoy, but thenyou lost the ability to potentially have more
children because for lack of a betterterm, trying to figure out what was
going on, and it was thisendometriosis and that such late diagnosis put you
in a position that by the timethey got to it. That's what they

(44:49):
did, right, And so Ithink that's where being proactive and your health
and vocal in your health, evenif it's uncomfortable and hard, you know,
even if it means you might haveto tell your doctor that you pissed
your pants, or hey, i'mhaving a hard time with you know,
intercourse, or maybe you don't havethe right doctor right now, maybe you

(45:10):
need to find a different doctor youfeel comfortable having these conversations, whether that's
an obgyn or you know, aprimary care And I do want to pause
here for a minute because I've talkedabout this before, but having the a
good doctor that you trust and isin your corner is so important. I

(45:30):
was incredibly grateful that I actually havemy primary care physician because I started missing
my periods when I was twenty andI wasn't pregnant, and I got referred
to an obgyn and that was thevery first doctor that I got on healthcare
with because I didn't have healthcare asa child, and so I was like,

(45:51):
hey, I'm missing my period,something's wrong. And that was the
first doctor that I created a relationshipwith, and she was incredibly kind and
caring and Leslie does a lot similarthings that you do. Is listens to
her patients and asks questions and isthere for the patient and spending time with
the patient. And she was theone who referred me to my primary care
who is also an amazing human being. And I've had him now fifteen years

(46:15):
and I can tell him the truth, and we've had tough conversations and we
haven't always agreed. But something I'vebeen flabbergasted by is I've had a lot
of people lately tell me that they'vehad doctors who just flat out won't listen
to them. They say they needsurgery when they're not asking they want to
try, you know, conservative approaches. They can't have a conversation with them,

(46:37):
and they just feel like they're doctorsin there for two seconds and can't
even you know, ask a question. And I think before we get to
any of the pelvic floor stuff,you know, you have to find those
doctors that are in your corner,and sometimes that might mean doctor shopping and
finding the right doctor for you,because not every doctor's going to be the
right fit for you. And Leslie, I see you shaking your head on

(46:58):
this one. Yes, yes,I agree, but yeah, so along
those lines, thank you for sharing, Lauren, and I'm sorry you had
to go through that because that's incrediblydifficult. But hopefully on the other side
of this, this conversation will helpsomebody to have that conversation. You know.

(47:20):
It's it's interesting. Yeah, it'sinteresting too, because those statistics are
really high. Leslie, I knowwhat I know. Yeah, yeah,
I know. It's uh. Iit's a tough one. It's a tough
one because you know, when youthink one and nine, when are we
in a room with you know,twenty thirty women, you know at least

(47:45):
two or three are going to haveit in that room. So it's and
it's it's not you know, it'slike Lauren said, it's not. Having
a hysterectomy is not a cure.The old thinking wise, it was due
to menstruation regurgitation, like it wasactually coming out the flopian tubes into the

(48:07):
interstition in the abdominal cavity and that'swhat was causing it. That has been
absolutely disproven by a very very smart, lovely doctor I named doctor RedWine,
who actually passed away this past yearand I was lucky enough to meet him
last year. It is actually inour embryology, it starts from there,
so it starts from when you're inthe womb. So it is absolutely not

(48:34):
so taking out the uterus is notgoing to stop that. It will.
You can excise it all out,and if you have a very good excision
surgeon, which I have names of, you know, a few handful in
the country that I recommend, Soif anyone needs those, I'm happy to
give that information out. You needa very good excision surgeon that's a specialist

(48:55):
in this, and you know theyneed to act in. Endometriosis has many
different appearances. It's actually you know, very hard to see if you're not
a trained eye in it. Soyou can excise it all out, but
it can also grow back. Sothat's the other thing. So that's why
taking rus out doesn't get rid ofit, you know, cure you of

(49:19):
endometriosis. So I just wanted tomention that in case anyone wanted more information
about that. No, that's agreat call out because that's an incredibly high
price to pay for something that maynot get rid of it right right completely
have your uters taken out or well, And as Leslie just mentioned, Uh,

(49:40):
the reason I had so many laparoscopicexploratory surgeries was for that exact reason,
and my surgeon explained it to me. He said, you know,
I go in there and I getevery single thing I can, but there
are microscopic little pieces that you knowthat as soon as they sew me up

(50:02):
and send me on my way,those microscopic pieces start to grow, and
then they grow and then they spread, and that's it's just kept coming back,
kept coming back and knock on wood. Like I said, I haven't
had an exorcision surgery since twenty twentyand it's twenty twenty four, so I

(50:27):
and like I I think. Ialso said, I'm pretty much completely through
menopause one hundred percent, so I'mfeeling I don't know if I should feel
safe or not, or it's gonnacome back with the vengeance. I don't
know. But fortunately it is hormonedriven. And also it's an inflammatory disease,
so you know, I do talkabout with patients there's very high inflammatory

(50:55):
causing foods, so you know,I'll just say I'll go over those with
them and you know, talk aboutstaying away from them because they usually will
their symptoms won't be as severe ifthey kind of stay away from those foods.
Can you just give a few examplesof maybe even like groups of food
to stay away from. Sure,but it's obviously all the good stuff.

(51:17):
It's I know, it's all thegood stuff. It's red meat, it's
alcohol, it's caffeine, it's gluten, it's dairy, it's sugar, it's
it can be night shade plants forsome people. But you know, which
are vegetables in that bloom at nighttime? So like tomatoes, potatoes, zucchini,
I plant things like that. Themain ones, honestly are is the

(51:42):
first like five that I said,So dairy, gluten, red meat,
alcohol, caffeine, sugar, Sodarn. And that's why people feel better
on fad diets as they cut thosethings out and they have less inflammation.
Yes, yeah, so it's goodfor your whole system. But yeah,
it's good for your whole system.And you know, again, I treat

(52:04):
a lot of patients with gut healthissues, but particularly with endometriosis. It's
an inflammatory disease, so that canthat is one piece of treatment that's helpful.
You know, while working with apublic floor physical therapist, a good
excision surgeon, you know, allthe all the good things like you know,
good amount of exercise, growth sleep. We call it sleep hygiene,

(52:27):
you know, doing stretching, youknow, mindfulness, diaformatic breathing. All
that kind of stuff is all thetreatments that we like patients with the chronic
pain condition to do, not justendometriosis, but all of them. Yeah,
And I think that's another good callout, Leslie, because I just
talked to a second ago about findingthe right doctors for you is something I've

(52:49):
learned in my journey with physical therapy, even as I've started using the term
care team, because I work closelywith my primary care an orthopedic surgeon and
physical therapists and even sometimes get otheropinions to then create like almost like a
long term care plan in that boththe short term and long term, you
know, to get the help thatI need because I don't want to have

(53:12):
eight hundred surgeries, you know,and thankfully I've not had to experience endometriosis
surgeries, but I've had three jointsurgeries in five years, all on the
right side, so I've been tryingto avoid that as much as possible,
And you know, I think thatkind of begs another question, is uh,
you brought up earlier that you getto spend a lot of time with
your patients, and I know wehad talked about insurance because that's another lovely

(53:38):
topic in the United States. IsI'm very grateful. And part of the
reason I said earlier that I didn'thave insurance as a kid was my mom
was a single mom and could notafford insurance. She worked for a small
law firm. They didn't offer,you know, affordable health care, and
so I until I worked for corporationand on my own, I didn't have

(53:59):
an insurance. And so now thatI'm an adult, you know, I
have insurance and I take full advantageof it. And people probably think I'm
crazy because I'll go to the doctorover silly stuff. But when you've been
in a position where you can't gothe doctor because you can't afford it,
I it sucks. Sometimes. Ican tell you I'm paying over ten thousand
dollars in medical bills some years,but I have to budget for that because

(54:21):
my physical health and mental health isjust as important. And I just wanted
to touch on that because we weretalking about insurance a little bit and you
said you had the you know,ability to maybe spend a little bit more
time with your patients, but itcomes with some logistical problems, right,
yeah. So you know, I'veworked in no patient clinics, you know,
for twenty years, and the issuewith insurance is that they are reimbursing

(54:46):
less and less, you know,as the years go on. So what
do you do in a no patientclinic. You have to cram in more
and more patients to make you know, any money as a clinic. And
you know, I used to seetwo, three, four patients an hour,
and you're running all day, andyou know, I want to give

(55:07):
the time that each patient deserves.And if I'm constantly, you know,
anxiously looking at my watch at likeoh god, one's coming in three minutes
and I'm nowhere near done with thispatient, I didn't want to do that
anymore. So I started working ata specifically only pelvic health physiotherapy clinic.

(55:29):
And it is a cash based clinic, which means, yes, you have
to pay. You can submit toyour own insurance, like we don't deal
with insurance companies at all. Youpay, we give you what's called the
super bill that has all your codesand ICD ten codes and everything on there
and you can self submit to yourown insurance, and I spend an hour

(55:50):
with every single patient. It doesn'tmatter, you know, the evaluation is
an hour. Every visit after isan hour. Because I want to be
able to spend the time with thesepatients and they deserve it. And you
know, if I was at anoutpatient you know, clinic that still accepted
insurance half the time, their copsare sixty five to ninety five dollars for

(56:13):
a copey. You know, Icharge one hundred and fifty dollars an hour,
but you get an hour with me, whereas you would have seen me
for maybe twenty thirty minutes at most, you know, in an outpatient office
without you know, going and doingexercises in the gym and stuff like that.
So I want to spend the fullhour with my patients. So that's
why I decided to do cash based, and you know, to be honest,

(56:36):
I think it works really really well, and patients want to be there
because they want to get better.So yeah, I think that's a great
call out too, because I unfortunatelyhave been dealing without a network insurance for
mental health lately. They were innetwork, now they're out of network and
it's just a headache, but it'sa headache sometimes worth having. Insurance sucks

(56:58):
either way. We all know that. Yes, but you know, I've
noticed without a network, you know, it's it's not as bad as I
thought it was. And I atleast get to see someone that I can
spend quality time with who knows mein the mental health setting, and it's
similar even in the physical health setting. Is being able to spend a whole
hour with a therapist or a doctoris so helpful because I know and even

(57:22):
to my normal PT clinic, theyhave to stack, you know, at
least two patients on top of eachother in the same forty thirty to forty
minute window. And you know,they're pretty good about being individualized care.
But like with pelvic floor therapy,like that's not going to happen now you're
doing some invasive stuff. I hopeyou don't. Yeah, it's so intimate

(57:43):
and you have so much to talkabout, and you know, sometimes patients
would want to you know, patientswant to talk for the first ten minutes
and just go over their homework,go over what they've been experiencing, you
know, all of that. Well, if you're seeing two three patients an
hour ten minutes, half your timewith them is gone. So when you
spend an hour with them, youhave plenty of time left over to get

(58:05):
to the manual work that you'll wantto do with them, so or exercises
or whatever you want to do,because yeah, you've got all hours.
So yeah, that's awesome. Sotalking about insurance and difficult to handle situations,
you know, I think it's interestingbecause we've mentioned a little while ago,

(58:25):
you had mentioned with when you're explainingwhat pt pelvic fourth pets do,
we had talked about male or youknow, men with without uterus's you know,
pelvic health is a thing too,and I think as much as women
don't know that exists, I'm verysure that a lot of men don't realize

(58:46):
that exists either. And I knowwe wanted to touch on that a little
bit because male pelvic floor health isjust as important as women pelvic floor health
as well. Yeah, absolutely,yeah, So yeah, it's very you
know common to think, you know, oh, women leak after having babies,
or postman a puzzle, you know, hormone changes. You know,

(59:07):
there's aisles and aisles of poise padsin every grocery store but we don't always
you know, think about men andmen have pelvis is too, Men have
bladders too, men have rectums too, so you know, they have you
know, just as many problems aswomen do with pelvic health and incontinence and

(59:29):
pelvic pain and things like that.So I mentioned earlier, I do see
a lot of male patients after havingprostate cancer removal surgery, which is a
radical protectivey. They are usually tendto be very incontinent right away. They
take out the internal sphincter. That'slike an involuntary sphincter, and all we

(59:49):
have left is our pelvic floor torely on after that. So teaching them,
you know, how to become continentagain is a big portion of it.
And also a rectile dysfunction. Ifthere's any nerve damage after that surgery,
there's things that we can do tohelp them with that. And then
also you know, I have alot of male patients with pelvic pain as

(01:00:10):
well. I have a lot ofyoung male patients that you know, have
you know, penile pain or tipof the penis pain or painless sitting in
their paraneum. You know, proustatepain usually presents as like sitting on a
golf ball, so they'll have youknow, even young again young patients with
that, and if their pelvic floorsare too tight or not functioning properly or

(01:00:34):
you know, then that's going tocreate problems as well. I have a
patient right now that had radiation tohis prostate and then there's tissue changes that
can happen due to radiation, andthey usually start six months up to four
years after radiation. So he hasa lot of urgency all of a sudden

(01:00:55):
in the last two years. Hehad radiation five years ago, and you
know, there's definite tissue changes,you know, around his bladder, and
he's got terrible urgency. But inworking with me for a few weeks,
his urgency is getting significantly better.So there's so many different things that we
can still see with men. Youknow, I'll have patients with coal rectal

(01:01:17):
cancer and you know, they'll havethe rectum removed and they'll have a colostomy
bag for a while, and they'llread the coal into you know, the
anus and you know, getting thema little bit more continent with their bowel
movements and just again working with allthat scar tissue in the empty minutes.

(01:01:38):
It's a lot so yeah, there'sa whole host of male pelvic issues that
they need to come in and seeme. And it's about half of my
patient lobe. I would say,yeah, when I started out in pelvic
pet it took about four years toget a man through a door. I

(01:01:59):
think two. That's also getting toknow where I am and or a pelvic
PT in their city. And youknow, now I have a very good
relationships with urologists in town and youknow, even ovgi ns in town.
But and then they know to sendthem to me. But I do,
we do see a lot of menat my office. Yes, I'm glad

(01:02:20):
to hear that that one men areseeking out help and getting referrals and that
you have those good relationships. AndI think that just kind of resonates with
what we were just saying about havinga care team and finding the right doctors
for you. And I think that'sanother thing too, is we had talked
a little bit offline of like howimportant it is to find resources right you

(01:02:42):
know, there's you might be ina remote area, and you had mentioned
that you have a network of pelvicpts all over the world, so don't
be afraid to reach out, youknow, We're here to desensitize these issues
and normalize these conversations. And youknow, I really appreciate you, Leslie,
coming on to talk about this andmore and sharing your own personal story,

(01:03:05):
because these are incredibly hard things totalk about, and Leslie, you're
a pro at it, we cantell, but it's hard, I think,
even in your profession, to bewilling to come on a podcast,
because you know, you got tobe careful with what you say, and
you know, but you have alot of good knowledge that's really important to
share. And I think the courageboth of you showed tonight has been incredibly

(01:03:28):
meaningful to me because I think theseare topics that are so so important and
I think we've brought up a lotof great points tonight. So before I
close out any last words last wordssounds so final, let's say, but
there is there anything else you wouldlike to share? Even I mess up

(01:03:49):
sometimes, guys, Miyan Alex.No, just that I'm so grateful that
you asked, you know, meto do this, and I'm happy,
very happy to be here and alwayshappy to educate on on pelvic health.
And yes, if anyone listening isyou know, having trouble finding someone like

(01:04:10):
me. There's a few websites youcan go to the APTA or national organization.
We'll have a pt locator and alsopelvicguru dot com. You can find
pelvicspecific therapist on as well as pelvicrehab dot com. You can find specific
therapists. And you know, ifanyone needs to reach out to me at
all and has a question, I'mhappy to answer. My handle on Instagram

(01:04:34):
is Below the Belt Physio and myoffice Instagram handle is Southwest Florida Pelvic Health.
So happy to answer any questions.And I would just like to say
as a public health patient that itmay it may sound strange, and it

(01:04:58):
may turn you off a freak youout of first, but trust the process
because this type of therapy really doeshelp. It's helped me in a few
different areas, not just the endometriosis. Like I said, I've gone back
to Leslie many times for even differentissues. But just don't be embarrassed about

(01:05:23):
it, don't. I mean,this is what they do, This is
what Leslie does for a living.Nothing you say is going to gross her
out. I know this personally,nothing well and if somebody gets into this
is my own theory is that ifsomebody gets into and does the education and

(01:05:44):
goes through everything to be a peltfor physical therapists, they really want to
help people like they're not going toget You don't need to be shy.
It can be awkward, it canbe weird, but just trust the process
because it is. It is wonderfultype of therapy that can help a lot
of people. That's the last thingI have to say, thank you,

(01:06:06):
Lareen. I meant to say toothat it's not like going to the gynecologist.
There's no speculum, there's no stirrupsto put your feet in. You're
not shoved to the end of thebed with your urse hanging off the table.
It is you are, you know, lying comfortably on the bed with
a gown draped over you, andI'm sitting next to you and using you

(01:06:29):
know, one finger for an examand I am this is the only way
to get to those muscles. Soit's just like treatment treatment anywhere else.
It's just happens to be in acave, as we say, but yes,
it is, it is. Youknow, we take it very seriously,
like Lauren said, and you know, we're very very happy to help
it. But yes, it's notIt's not as scary as it sounds,

(01:06:50):
and we hope that you feel verycomfortable coming in to go through this with
us. Awesome. Yeah, thankyou so much for wearing that perspective to
Lauren, because I agree with you. I my pelvic floor therapist. I
believe the first session was very similarin that she kind of went over what

(01:07:13):
it was, but like I didn'tknow what to expect either, and she
was just so nice and sweet andcalm, and I was just blown away,
and I thought I would be waymore uncomfortable about it than I was.
And after a little while, youknow, I'd ask her questions about
public floor therapy. I'm like,do people get weirded out all the time?
And she's just what, it's theright question. She was so so

(01:07:35):
sweet. But to your point,Lauren, like people who get in this
profession do it because they care,you know, And I've only had positive
experiences in that realm. So definitely, if if you feel like you're in
a position where public floor therapy mayhelp, reach out to your care network,
have a referral or will also postthe links that Leslie mentioned also in

(01:07:56):
the podcast episode notes so you caneasily get to them. And I do
want to give a shout out toLauren to at Lauren Sample's Underscore FLA for
Florida. She does a lot ofgreat work in the true crime space and
her nonprofit, The Florida Famous Project, is super fantastic, so definitely check

(01:08:18):
her out. She's authentic and realand tries to do the right thing for
her entire community and I think that'sincredibly important too. Thank you so much,
Alex anytime, So, Leslie,Lauren, it was so lovely to
have both of you. Your dynamicwas wonderful and for both of you to
share. Leslie, I will behappy to have you on anytime. I'm

(01:08:41):
sure this episode will stir up someconversation, so I'll have to let you
know what our next topic is.Yeah, thank you so much for having
me, and I would be happyto chat with you anytime. Yes,
all right, Well we've officially normalizedthe conversation on Colvid flor physical therapy to
day. I'm definitely digging into thatendometriosis and we'll continue on normalizing these topics.

(01:09:05):
But that's it for today, andI hope our listeners go out and start normalizing