1st Anniversary of Potentially Faulty Pelvic Floor (Or how I became a self-selected member of #PelvicMafia)

I had no idea this morning when I logged on to post a (late) entry about how I got interested in pelvic health in the first place that I officially started this blog exactly 1 year ago. In some ways that’s frustrating because that means that I’m still searching for answers far longer than I expected, but in others it’s encouraging because in going through some old posts I realized that I’ve come through the other side on some really hard stuff and have found a way to let it strengthen me, without defining me. Independently of the timing, I wanted to reflect on where I am by considering where I’ve been.

I spent the 5 years before I went to PT school absolutely positive that I wanted to be a pediatric PT. I wanted to snuggle babies and help kids learn to walk for a living. When I got to Georgia State University, I applied for a job as a teaching assistant in an undergraduate anatomy and physiology class to help me curb the cost of my out-of-state tuition. In order to be considered for the position, I had to attend all of the lab sessions, pass all of the tests, attend weekly TA meetings, and perform a teaching demonstration. For my demonstration I chose reproductive anatomy and physiology – as an undergraduate I was part of a Health Outreach Peer Education (HOPE) group, and had given talks to undergrads regarding sexual health and anatomy, so I felt comfortable with the material. I felt comfortable, at least, until I began to prepare my (two hour?!) lab session and realized that these 18 year old “kids” from GA may never have had sex ed before. I realized that the first time they heard the words “fallopian tubes” may be out of my mouth. I felt the weight of that responsibility, and really wanted my lecture to be as accurate and relateable as possible, particularly after asking some of my Georgia native classmates about their sex-ed experiences. (In one conversation my classmate told me that the extent of what she learned about sex was that having multiple sexual partners in life was like trying to move a piece of tape from one sweater to another – it just didn’t stick as well. With subsequent class demonstration of said tape. )

In my quest to provide such a lecture, I reached out to my old HOPE advisor, Eric Garrison, who is a clinical sexologist and one of the best public speakers I have had the pleasure of listening to, asking for advice. He gave me the names of some really well-known people in the field of sexual health, and I cold-called these people via email asking for help in the form of slides, materials, or just some good vibes. One of these people was James Trussell, a researcher at Princeton who ran the studies regarding efficacy rates for contraception. When the birth control pill handout says that the pill is “98% effective”, he is the person responsible for figuring that out. Not only did he respond to my email, he offered to send me some of his research, and that research ended up being chapters from a book that is a resource for physicians who prescribe contraception – all about mechanism of action, efficacy rates, etc. Additionally, after seeing my mailing address, he offered me entrance to a conference being hosted in Atlanta for contraceptive technology. At that conference, I was likely the only attendee under 30 and surely the only one who was not, nor ever planning to, prescribe contraception. I was out of my league and in over my head, but that conference was one of the defining moments in my decision to go into pelvic health. Attending the conference was my first exposure to some of the disparities in the healthcare of women, and the window through which I found out that there was something I could do about it as a physical therapist. At that conference I attended a lecture talking about flibanserin, a drug marketed as the “female viagra”. That was the premise anyway; the reality was that the discussion was about libido differentials in relationships, possible causes for those differentials, and the healthcare provider’s role in assisting patients with concerns regarding libido. The speaker made a point that I hadn’t yet considered about sexual relationships – libido discrepancies are often spoken about and treated as a female issue, arising from some lack of mental interest, rather than an issue with a possible musculoskeletal nature. Patients, she asserted, were sometimes not interested in sex because it was painful due to muscular dysfunction, and that was something that could be addressed with pelvic floor physical therapy.

I went from being 100% certain that I wanted to work with kids to realizing that the topics I am most interested in talking about are a bit more … adult in nature. Ditto the research I want to read. Ditto the things that get me going (I’m sorry, I couldn’t help myself. I mean the topics that I am passionate about: healthy relationships, female empowerment, equal access to health care.)  And the more I talked about these things the more I realized that I was very comfortable talking about topics that many other people were not, and that that could be my superpower.

So that’s how it all started: trying to mitigate my student debt led to trying to teach a class, which led to cold-emailing people far out of my league, which led to saying yes to a conference I had no business being in, which led to me finding out where my passions are in healthcare and that my lack of conversational boundaries could be used as a force of good (and not just to me getting a paper plate award for being “Most Likely to Embarrass You in Front of Your Parents”). Where it has led me has been awesome – it has led me to being a patient advocate, to teaching anyone who will listen to me (and many that would prefer not to) about the role of the pelvis in musculoskeletal dysfunction, to empowering my classmates and friends to have healthy sexual relationships, and to consider my own health journey in a new light.

P.S. I know that “embarrass” is spelled incorrectly on that award, but I think that just adds to the charm.