Half the problem with pelvic health dysfunction is that people become secretive about it and don’t disclose it to their partner, their best friend and strangely not even their doctor. Yes that’s right – 65% of women and 30% of men sitting in a GP waiting room report some type of urinary incontinence, yet only 31% of these people report having sought help from a health professional. (1) There is shame attached to urinary and faecal incontinence and so for this reason women and men struggle on alone, going to Coles to purchase pads to hide their condition and feel isolated and fearful about the future – their ageing future and what does it hold for them?
So how do most patients make their way to see a pelvic health physio?
Referrals from GPs? Yes some do and thanks to the wonderful work of the Continence Foundation of Australia, the peak body for Continence Promotion in Australia, the GPs (and all health professionals) have at their disposal, wonderful printed resources in English and many other languages to give handouts to patients about pelvic floor dysfunction and its management. Pelvic health physios (actually all physios) are first contact practitioners and as such patients don’t require a medical referral to see them – you can just walk in off the street.
The Commonwealth Government also has a Medicare programme called an Enhanced Primary Care Plan which recognizes urinary incontinence as one of the chronic conditions that can be included in a plan. This entitles the patient to $53.80 rebate on their consultation cost for up to 5 visits which helps defray the cost of a consultation with a pelvic health physiotherapist if you don’t have private health cover. Make sure you check with your GP to see if you are eligible for a plan.
Referrals from urogynaes/gynaes? Definitely! The recent release of the Australian Commission on Safety and Quality in Health Care document emphasizes the importance of first-line conservative management of stress incontinence and prolapse conditions for women (meaning pelvic floor muscle training PFMT, the knack – engaging the pelvic floor muscles prior to increases in intra-abdominal pressure, lifestyle advice such as defaecation dynamics and the use of a pessary where possible). So don’t be surprised when you consult with a surgeon and the first thing they do is refer you to a pelvic health physiotherapist.
But many patients come via secret whispers or the ‘ripple effect’. One friend seeks help, gets cured (up to 85% achieve this) and finds life much more fun without urinary incontinence; and tells another friend who gets a pessary fitted and is able to exercise with gay abandon; and she tells her Aunty (who has frequency) and after only a few visits, can suddenly go to the theatre after all, because she isn’t terrified of being trapped in the middle seat in the Dress Circle with a busting bladder; and Aunty’s neighbour is incredulous and immediately rings for an appointment next week.
Things are definitely improving regarding the secrecy surrounding pelvic floor dysfunction, but there’s still a long way to go and I am thankful for the way women can share their successes with their tribe, so others may seek help for this lonely condition.
Because pelvic floor dysfunction can make you lonely.
It stops you going on bus trips with PROBUS or your Rotary club. It makes you think twice about going on the bush walk arranged by your friends. It insidiously causes you to refuse an invitation to learn Salsa dancing. It can make you feel trapped inside your own home.
Don’t be trapped by your pelvic floor dysfunction. Treatment strategies are often ridiculously simple, common sense behaviours; changes in long-held beliefs and habits and simply finding the seemingly elusive pelvic floor muscles and learning how to activate and strengthen them.
I hope this helps you realize your potential with your own pelvic floor (and bladder and bowel) by encouraging you to seek out a pelvic health physiotherapist. If you live in Brisbane, give my secretaries a ring on (07) 38489601 or (text) 0407659357 and make an appointment to see Megan, Jane, Martine, Alexandra or myself and start living a full life again.
Living life to the fullest
- (Byles & Chiarelli, 2003: Help seeking for urinary incontinence: a survey of those attending GP waiting rooms, Australian and New Zealand Continence Journal).