Monday, April 27, 2015

A Day in the Life | Pelvic Floor

I am so excited about today's Day in the Life! Lindsey is an OT who specializes in treating pelvic floor disorders. This is such an interesting practice area and I'm so happy that she's here to share what a day in her life looks like!

When in grad school for OT, I remember recognizing a pattern of practice areas that I found the most compelling: psychosocial issues. I gravitated towards these topics whenever we had a guest lecture or read a journal article. And this interest area made sense to me, in fact it’s one of the main reasons I pursed OT over PT. OTs have a fabulous way of looking holistically at dysfunction; we recognize the role that mental health plays on physical injury. In fact, as a profession, we have deep roots in the mental health field. OT had its origin in the 1700's during Europe's "Age of Enlightenment." At this time, radical new ideas were emerging for the mentally ill. During this new era, concern was given to their mental well being. The doctrine of Moral Treatment utilized occupation; goal-directed use of time, interests, energy, and attention; in combination with purposeful daily activity for treatment.

I specifically remember a lightbulb moment for me. The latest copy of OT Practice arrived in the mail and the cover story was “Treating Incontinence and Pelvic Floor Disorders.”  I was sold! Specializing in this practice area had such an opportunity to enhance quality of life by empowering people to continue participating in their daily activities!

I started The Functional Pelvis, a private practice specializing in pelvic floor muscle dysfunction so that I could do just that: empower and enhance quality of life of men and women. 

A day in my life means carefully planning out what areas of Manhattan I am going to be. The reason is this is so important is because I do “house calls.”  I don’t treat in a clinic or busy gym. I find outcomes are greatly enhanced for my clients by treating them where they are the most comfortable. I pick certain days of the week to be at certain neighborhoods. I also spend a certain portion of my week educating both doctors and the community about the role of a pelvic floor therapist. It’s amazing just how little is known about what we actually do and how we can help. We often pick up where other practitioners stop. We see our clients weekly and in my case, for an hour or more. We have the time to talk with them in detail about their habits and behaviors, which plays such a significant role in pelvic health. And certainly a large part of my job is helping them feel comfortable to open up to me about what can be very embarrassing topics. 

What I am referring to are issues of the pelvic area like pelvic pain, pain when you have sex, frequent urges to urinate, incontinence, bladder leakage, and bowel issues.  This is the stuff we used to laugh about as kids, but as we're grown-ups and it's not really so funny anymore. 

I assess my client’s pelvic floor muscles to evaluate for weakness, endurance and range of motion – just like we do for any other part of the body! For manual muscle testing, we use the modified oxford scale.

A big portion of my session is spent in education: ways to take better care of the pelvic floor, discussing the importance of posture, the role of fiber and water on elimination. I find it such a privilege to enable people to talk about topics that can often be challenging to discuss; I enjoy helping them to feel comfortable and at ease. Once they find pelvic rehab, I often hear how comforting is it that someone finally understands the challenges that they have been dealing with for often many years. The topics that I discuss and treat are often overlooked by most practitioners either because they don’t know how to ask the right questions or the patient may be uncomfortable to bring it up. I have heard topics like incontinence described as the “hand on the doorknob” conversation. If a patient actually feels comfortable bringing it up to their gynecologist or general practitioner, it may be as they are leaving. I take great pride in that these same topics are brought up when my patients walk in the door, not when they leave.

About Lindsey:

Lindsey Vestal graduated from NYU with a Masters of Science in Occupational Therapy. She has specialized in functional pelvic health rehabilitation and has worked with a variety of populations and disorders including: Fecal & Urinary Incontinence, Constipation, Dysparunia, Vulvodynia, Prolaspe, Pre- and Post-Partum Women, and Pelvic Pain Patients. She has trained with Herman & Wallace and Maitland on Pelvic Floor therapy as well as specialized biofeedback training for the pelvic floor.

As an OT, she is a passionate promoter of bridging musculoskeletal pelvic floor rehabilitation as well as lifestyle modifications and addressing the physiological impact that pelvic pain and/or incontinence has on the lives of everyday women.

Prior to founding her own practice, Lindsey was an Occupational Therapist at Roosevelt Hospital in Manhattan. Lindsey lives in Manhattan with her husband, 12 year old lab, and two children.

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