No Surgery, No Drugs, Just You…

Do you leak with exercise? Feel an urge to go to the bathroom when you sneeze, cough, or laugh? Do you wear a pad just in case? If so, you may be experiencing incontinence… And you don’t have to live with it. Now you can exercise your way to control, freedom, and peace of mind.

Northwest New Mexico Women’s Health Specialists offers one of the most comprehensive Pelvic Floor Rehabilitation programs in the state. Our eight week program teaches proper recruitment of pelvic floor muscles by integrating biofeedback, electrical muscle stimulation (EMS), and behavioral techniques. It is a completely pain-free process,  performed in a calming and private office setting by a trained professional. It is a highly effective program and is accepted by most insurances. Talk to your physician today about scheduling an evaluation.

Dr. Daniel Chang, Dr. Joseph Szekely, Dr. Sheila Cepeda, Dr. Kristean Thorpe

Our program clinician is Patty Jalomo, a registered nurse with more than 15 years experience in women’s health nursing. She has been trained in pelvic floor muscle evaluation, treatment of pelvic floor muscle dysfunction, biofeedback, electrical muscle stimulation, therapeutic ultrasound, and visceral mobilization. She is board certified by the Biofeedback Certification International Alliance (BCIA) with a specialty in Pelvic Muscle Dysfunction. She is also an ICEA certified childbirth educator, Ace certified personal trainer, and ACE certified lifestyle and weight management coach. She is currently working on a Bachelor of Science in Nursing degree through Eastern New Mexico University. She is the mother of two children and enjoys running, reading, and teaching Zumba and Aqua Zumba.

FAQ's:

Q:  My doctor tells me I have urinary incontinence, but I’m only 35 years old! How is that possible? I thought only elderly people suffered from this.

A:  More than 17 million Americans suffer from urinary incontinence and over 85% of them are women. Incontinence can affect people of all ages and is not considered a normal part of aging. Often, the problem is present after childbirth, but there are numerous reasons for developing incontinence. Make sure you tell your doctor that you are experiencing incontinence so that an appropriate diagnosis can be made and a treatment plan developed that is right for you. You do not need to alter your lifestyle because of this problem. Treatment options, like pelvic floor rehabilitation, can be very successful in alleviating your symptoms.

Q:  What is stress incontinence?

A:   if you leak urine when you sneeze, cough, or laugh, you are experiencing stress incontinence. Stress incontinence occurs when the muscles under the bladder are weak (often due to childbirth). Aerobics, running, walking, or heavy lifting can also cause this problem. Stress placed upon the bladder during these activities causes the bladder to leak.

Q:  I take prescription drugs for incontinence, yet I still leak when I have a strong urge to go to the bathroom. Can I be helped?

A:  Urge incontinence occurs when an overwhelming feeling to void happens and you are not able to make it to the toilet in time. This type of incontinence usually causes a greater problem than stress incontinence. It can be due to a false signal sent from your bladder to your brain and back, telling your bladder is time to empty. Often times, people with urge incontinence go to the bathroom frequently in an attempt to stay dry. It is possible to retrain your bladder through bladder control techniques and behavioral modifications. Talk to your doctor to see if pelvic floor rehabilitation may be right for you.

Q:  What if I am planning on having surgery for my incontinence?

A:  There are other options of treatment available for urinary incontinence, including medications and surgery. These options are dependent upon the type of symptoms that you are having. Unfortunately, medications have side effects, and surgeries are often times not a fix-all. It is important to learn how to keep your pelvic floor muscles strong, even if you are planning to have surgery, as this actually makes the surgery more effective. Pelvic floor rehabilitation programs have been shown to be just as effective as medication or surgery, provided the patient completes the program and puts forth the effort to finish the home exercise regimen that is prescribed.

Q:  What if I complete the Pelvic Floor Rehabilitation program and I still leak?

A:  If you are not showing improvement after completing the program, talk to your physician about other options. Depending on the type of incontinence that you have, your physician can potentially offer additional recommendations to help alleviate your symptoms so you can  get control of your bladder,  and your life.

Q:  What other problems can be treated with Pelvic Floor Rehabilitation?

A:  Because many different problems can be caused by tension in the muscles of the pelvic floor, relieving this tension can treat such things as pelvic pain (that is not related to other causes) urinary and fecal incontinence, urinary frequency, urinary retention, bedwetting, pain with intercourse, or pelvic prolapses.

Q:  I’ve heard of a new procedure that has been noted to be very effective for treatment of overactive bladder symptoms called InterStim. Is this something that is offered in your clinic?

A:  Yes, our physicians do offer InterStim as a treatment for urge incontinence and overactive bladder, if behavioral methods proved to be unsuccessful. Click this InterStim link for more information.

Definition Of Terms:

Stress Incontinence:  Stress incontinence refers to the accidental leakage of urine brought on by physical activities such as sneezing, laughing, coughing or exercise.

Urge Incontinence:  Often associated with symptoms of urinary frequency, and frequent nighttime voids, urge incontinence is leakage associated with a sudden overpowering desire to urinate.

Overactive Bladder:  The combination of urinary frequency, nighttime voiding and urge incontinence.

Mixed Incontinence:  Many patients suffer from a mix of both stress and urge incontinence. If you suffer from this condition, you generally will leak both with and without activity. You may be very wet, requiring the use of multiple pads per day.

Overflow Incontinence:  Overflow incontinence may occur when the bladder does not empty properly due to obstruction of flow (as can occur within an enlarged prostate in men), or from a weakened bladder muscle. Over time, the amount of urine in the bladder builds up and exceeds the capacity of the bladder, causing leakage.

Rectal or Fecal Incontinence:  Rectal incontinence is the loss of normal control of the bowels. This leads to stool leaking from the rectum ( the last part of the large intestine) unexpectedly.

Dyspareunia:  Painful intercourse, often caused by increased tension in the pelvic floor muscles, making penetration painful.

Prolapse:  When the pelvic organs drop and press against the vaginal walls due to the supporting structures stretching, pressure or a sense of fullness or heaviness occurs in the vagina. This can create pain in the lower abdomen, groin, or back. Sometimes urinary symptoms may also occur with this.

Pelvic Pain:  Pelvic pain can be defined as pain located below the navel and between the hip area that lasts more than six months. This pain can be due to vaginissmus, vulvodynia, pudendal neuralgia, interstitial cystitis, endometriosis, painful bladder syndrome and/or post-hysterectomy.

What To Expect In Treatment:

The Pelvic Floor Rehabilitation program consists of an initial evaluation, followed by eight weekly treatment sessions. The initial evaluation will include discussion with the clinician about symptoms, education regarding the musculature of the pelvic floor, and a pelvic exam to check for any muscle tension, pain, spasm, or pelvic organ prolapse. the weekly treatments will be approximately one hour each week, and the patient will be introduced to behavioral modifications, educational videos, biofeedback and electrical muscle stimulation, as well as manual muscle therapy or therapeutic ultrasound, as needed.

There is no pain involved with these visits, in fact the goal is to make it as comfortable as possible for the patient, to encourage relaxation of the pelvic floor muscles. If at any time the patient is uncomfortable with the treatment, they are encouraged to discuss this with the clinician in order to look for an alternative method of treatment.

Patients will be given an exercise program to practice at home and improvement will be monitored weekly. The key to success is being committed to the program. In a recent study of patients that completed the full eight weeks of treatment, 98% showed improvement in their symptoms, while 2% remained the same. Although many patients are initially skeptical, those that put the time into using the techniques generally see significant improvement.

Problems That Can Be Treated:

Many problems can be related to pelvic muscle dysfunction, and can be treated by Pelvic Floor Rehabilitation. Urinary issues include urge and stress incontinence, mixed incontinence, retention, frequency, overactive bladder, post void dribbling, and nocturnal enuresis (bed-wetting). Fecal incontinence and constipation can be treated, as well as pain issues including dyspareunia (painful intercourse), vulvodynia (burning pain on the vulva), vaginsimus (painful penetration), interstitual cystitis (bladder pain), and other non-specific types of pelvic pain

What People Are Saying About PFR

“When I was referred to Northwest New Mexico Women’s Health Specialists for Pelvic Floor Rehabilitation, I was really skeptical as to its effectiveness. Dealing with urinary incontinence was problematic for me especially during exercise. But there were definite results as I no longer woke in the middle of the night to run to the bathroom. Most importantly, I was consciously able to control the incontinence during sneezing or coughing and particularly during exercise. I am no longer a skeptic, but a believer that training, or in my case, re-training the pelvic floor muscles can absolutely make the difference in managing incontinence. So even after two months, I am still squeezing for 20 and relaxing for 20… It really works!” CJT

“This is a very helpful program. I did very well as long as I stayed with the exercises, but the minute I stopped, the problem resumed… My fault… I’ll get back on it.” NL

“I suffered from unexplainable pelvic pain for 13 years and saw numerous doctors who could not diagnose me. I desperately needed to find a clinic who would be willing to find the root cause of my pain. Daily life was difficult, emotionally and physically draining, but I made another attempt and gave Northwest New Mexico Women’s Health Specialists a chance. From the moment I made the appointment, to the moment I met Patty, I knew this was the place where I would get the help I needed. Dr. Thorpe’s compassion and commitment to my treatment as well as Patty’s diligence and care led us to the root cause of my pain, interstitial cystitis. The Pelvic Floor Rehab significantly decreased my pain level, causing my daily life to be more enjoyable. The rehab was easy, relaxing and effective in correcting my pelvic floor dysfunction. I am forever grateful to everyone at the clinic and would highly recommend the rehab treatments to women who have pelvic pain.” LE 

“Before I started the PFR program at Northwest New Mexico Women’s Health Specialists, it was not unusual for me to void 15 times a day. Wherever I went, I made sure that I knew where the bathroom was. During the course of the program, I learned that my bladder was really not full every hour, and that I was letting my bladder control me, instead of the other way around! By starting a program including scheduled voids and techniques to reduce the urge, I was able to gradually re-train my bladder to hold more urine. I am now able to hold my bladder or 3 to 4 hours during the day, and have completely stopped taking any medication for this problem. I would recommend this program to anyone who wants to leave this was just a problem you had to live with, because you can get your life back!”  PG