prolapse

January 20 2023

Everything’s Funny: Running, Motherhood, and Physical Therapy with Laura Green (@lauramcgreen)

Carrie Pagliano Active Mom Podcast Cheryl Iglesia, new mom advice, pelvic floor, postpartum, postpartum return to run, prolapse

Today I speak with Laura Green, a comedic content creator who loves to stand in front of people and tell jokes. Her brain is a hamster wheel of self deprecating humor focused on the run and fitness industry which she attempts to communicate via short videos and storytelling. She runs a lot. And she also naps a lot. Laura lives in Massachusetts with her husband and two young boys. We talk about Laura’s experiences postpartum and how she handled returning to run after each of her births.

Laura tells us about working as a travel physical therapist and how she has now found a niche pointing out the humor in life, making people laugh on social media. If you’re ready for a good laugh, then this conversation is for you!

We talk about:

-pelvic floor physical therapy

-returning to run after baby

-working as a physical therapist

-identity as an athlete and mom

-struggling postpartum

-starting slow with running postpartum

-finding the humor in motherhood and running

-asking for help

Time Stamps

1:00 introduction

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH LAURA

IG: https://www.instagram.com/lauramcgreen/

Website: https://www.lauramcgreen.com/

The Active Mom Postpartum Podcast is A Real Moms’ Guide to Postpartum for active moms & the postpartum professionals who help them in their journey.

This show has been a long time in the making!

You can expect conversation with moms and postpartum professionals from all aspects of the industry.

If you’re like me, you don’t have a lot of free time (heck, you’re probably listening at 1.5x speed), so theses interviews will be quick hits to get your the pertinent information FAST!

If you love what you hear, share the podcast with a friend and leave us a 5 start rating and review. It helps us become more visible in the search algorithm! (Helps us get seen by more moms that need to hear these stories!!!!)

Listen on Buzzsprout:

https://youtu.be/M7cyRJTkDyk

January 13 2023

Prolapse & Urogynecology with Dr. Cheryl Iglesia

Carrie Pagliano Active Mom Podcast Cheryl Iglesia, new mom advice, pelvic floor, postpartum, postpartum return to run, prolapse

Today I speak with Cheryl B. Iglesia, MD, FACOG, FPMRS. She is Director of the Section of Female Pelvic Medicine and Reconstructive Surgery (FPMRS) at MedStar Washington Hospital Center and Director of the National Center for Advanced Pelvic Surgery (NCAPS) at MedStar Health, an internationally renowned center that combines urogynecology and minimally invasive gynecologic surgery.

She is also Professor of Obstetrics/Gynecology and Urology at Georgetown University School of Medicine. As a double board-certified physician in Ob/Gyn and female pelvic medicine and reconstructive surgery with more than 30 years in the field, Dr. Iglesia specializes in diagnosing and treating pelvic floor disorders, including urinary incontinence, fecal incontinence, overactive bladder, and pelvic organ prolapse. She also specializes in treating complex pelvic floor complications after prior surgery, including urinary and bowel fistulas; complications after pregnancy and childbirth, including pain from episiotomies and lacerations, as well as accidental bowel and bladder leakage; and complications after cancer treatment, such as sexual health issues and vaginal dryness. She has special expertise in managing complications associated with transvaginal mesh and its removal.

Dr. Iglesia is also one of my very first mentors in urogynecology, in fact, we go back 23 years!

We talk about:

-finding facts on social media

-changes in management of pelvic organ prolapse

-starting with conservative care

-high tone affect on POP symptoms

-breastfeeding and affects on symptoms

-talk around the 4th trimester

-collaborative care

Time Stamps

1:00 introduction

3:15 fear surrounding pelvic organ prolapse

10:00 conservative care before surgery

18:14 pelvic floor prolapse or decreased tone

26:45 recommendations for getting additional care

28:45 tissue healing and RED-S

30:10 PTs collaborating with surgeons

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH CHERYL

IG: https://www.instagram.com/cbiglesia/

Website: https://www.medstarhealth.org/doctors/cheryl-bernadette-iglesia-md

Listen on Buzzsprout:

October 14 2022

Evidence-Based or Marketing Scam?

Carrie Pagliano Blog pelvic floor, postpartum, postpartum rehab, prolapse

At least once a week I get a DM asking me for my opinion about an exercise program or some other quick bite of Reel-style information.

And frequently, there’s a catchy (and sometimes fantastical) claim:

“Prevent pelvic organ prolapse with this program!”

There are two ways to understand a claim like this: from a medical perspective and from a marketing perspective.

I understand that people are selling things (no shame in that game, I sell stuff, too.)

But when the claim is all pelvic organ prolapse is preventable, my bullshit meter starts to go off.

POP is multifaceted and complicated. So, selling something with the promise that it will prevent POP, is disingenuous at best.

There’s a way to have that conversation without making impossible promises.

A program can offer education and prevention based on what we know, without promising the moon.

But to claim to have the answer for everything and say something is totally preventable, well that’s just a lie.

Programs like these are setting people up for disappointment and a false idea of what is possible.

We need to be critical of these big names. They are big names because they have big marketing budgets. Not because they’ve figured out the Secret Sauce of postpartum prevention.

We can’t be okay with this overstepping of what the evidence supports.

Fear Mongering is a marketing tactic.

I’m not saying these programs are bad, but they are overpromising and under delivering.

Tell me your thoughts. I’d love to know what you’re seeing out there.

https://youtu.be/-LHmOcfEwI8

October 5 2022

Expanded Coverage for Postpartum Care

Carrie Pagliano Blog csection, pelvic floor, postpartum, postpartum rehab, prolapse, research

1 minute to make your voice heard

Use this quick link to ask your US representatives to support coverage of postpartum care.

https://www.votervoice.net/mobile/APTA/Campaigns/97870/Respond?vvsn=BygfgA5sACO5XAMdNza7EBA

H.R.8181 – Optimizing Postpartum Outcomes Act of 2022

This is a bill that’s coming before the House of Representatives in the United States. You have the ability to use this quick link and MAKE YOUR VOICE HEARD! THe quick link allows you to use the auto text or add your own words to personalize the message.

The fact that ANYTHING related to postpartum is coming for a vote, is a huge win and we NEED to support it!

Some of my pelvic health colleagues have been integral in getting this to happen. THey’ve done their part, now it’s time to do ours.

If we can get postpartum care covered federally by medicaid, it will spill over into insurance care!

Let’s remove as many barriers to entry as we can and expand coverage for the much needed support moms need postpartum!

September 28 2022

Do C-sections prevent prolapse?

Carrie Pagliano Blog csection, pelvic floor, postpartum rehab, prolapse, research

I’m going to warn you, this is real life.

This advice was ACTUALLY published in a journal.

C-sections and smoking cigarettes are protective against pelvic prolapse.

This is what we have? Seriously? It just goes to show how little we know about prolapse.

How about this? What if the risk factor for prolapse is just getting pregnant and giving birth, REGARDLESS of method.

Are we really telling people that smoking will protect you from experiencing pelvic organ prolapse?!? REALLY?

In this day of promoting being evidence informed, I think we really need to focus on what questions are being asked and what questions are being answered.

If you’re not considering all the factors, be aware you’re not considering all the factors

Am I supposed to be telling moms to have a c-section and start smoking?

Come on.

What do you think? What would you do if someone actually gave you that advice? What are some other silly things you’ve read or been told?

September 22 2022

Is more information about prolapse a good or a bad thing?

Carrie Pagliano Blog pelvic floor, postpartum rehab, prolapse, research

The good news about social media is you have easy access to information.

I get DMs all the time from moms who must be frantically searching the internet for “what’s wrong with me” at 2am.

What I tell a mom who is 2 weeks postpartum will be DRASTICALLY different from what I tell a mom who is 2 months postpartum.

In those early weeks, things are changing SO FAST.

Milk is spraying from your nipple a million different directions

You have night sweats

You probably still have discharge

If you had a c-section, you’re recovering from that.

Your uterus is shifting.

Then there’s the constipation.

There’s A LOT going on.

In those first few weeks, here’s what you should do…

Notice…but don’t freak out.

Especially if you have never looked down there before and postpartum is your first time checking things out, well, you don’t even know where things started!

It’s so hard to not freak out when you’re scared.

Go ahead and gather information, talk to KNOWLEDGABLE providers, and know that things will continue to change.

But if the knowledge is overwhelming you, then just stop looking! More information isn’t always better.

September 9 2022

Prolapse, Hormones & Urogynecology Dr. Jocelyn Fitzgerald

Carrie Pagliano Active Mom Podcast Jocelyn Fitzgerald, new mom advice, pelvic floor, postpartum, postpartum rehab, prolapse

Today I speak with Dr. Jocelyn Fitzgerald, Assistant Professor Urogynecology and Pelvic Reconstructive Surgery, University of Pittsburgh. Recently, she had a tweet go viral talking about what a terrible job we do about educating women about their bodies and we unpack that in our conversation. We have a candid conversation about prolapse and why so many professionals think women shouldn’t be education about the possibilities BEFORE they are pregnant. Jocelyn talks about how patients can find the right type of provider to care for the symptoms they are experiencing. So much has changed over the years with how women get care for prolapse. We talk about those changes and current options that exist.

Jocelyn is committed to equity in women’s health and supports the Magee Women’s Research Institute. If you’d like to donate to women’s health and know that the funds are going directly into the hands of real scientists on a singular mission of bringing women’s health to where men’s health has been for 100 years, the Magee Women’s Research Institute is doing just that.

We talk about:

-educating women about their bodies

-stages of pelvic floor prolapse

-the role age plays in experiencing prolapse

-the brain’s interpretation of pain and sensation

-when pessaries can help

-tailoring care for each patient

-outreach

Time Stamps

1:00 education decreases anxiety

4:00 common types of prolapse and the spectrum

9:30 how people experience prolapse differently

15:28 navigating options for care and pessaries

22:00 how options have changed

28:45 advice for women in postpartum

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH JOCELYN

IG: https://www.instagram.com/jjfitzgeraldmd/

Twitter: https://twitter.com/jfitzgeraldMD

Website: https://www.obgyn.pitt.edu/people/jocelyn-fitzgerald-md

Magee: https://mageewomens.org/support/ways-to-give

Watch Episode on YouTube:

Listen on Buzzsprout:

postpartum body changes prolapse words matter

September 7 2022

Words Matter! | Let’s talk about postpartum body changes

Carrie Pagliano Blog leakage, pelvic floor, postpartum rehab, prolapse

“Damaged”

“Broken”

“Oh, no!”

And my personal favorite…

“I’ve never seen anything THAT bad.”

Words matter!

Especially in the context of postpartum issues, specifically prolapse.

I was talking to a client who had surgical intervention and she was told by the doctor that things were “damaged”.

Now THAT’S a heavy word choice.

Damaged to me means broken, things won’t get better. That makes me SCARED (which I can tell you can actually make symptoms worse, if your problem is overactivity)

IT DRIVES ME NUTS!

Providers, we really need to watch what we are saying to patients because we are scaring them!

Imagine, if you think you are damaged beyond repair, are you going to hold out hope for a return to normalcy? NOPE.

We are just making an already hard thing even harder for moms.

A lightbulb can be broken.

Your can can be broken.

A mom CANNOT be broken!

We need to be cognizant of the words we are using when we are talking to moms about the changes that have happened with their postpartum bodies.

Share with me, what experiences have you had with these situations?

August 31 2022

Should we stop trying to have “perfect form”?

Carrie Pagliano Blog leakage, pelvic floor, pelvic floor physical thereapy, postpartum rehab, prolapse, running form

Can “perfect” running form cause leakage?

Does that question even make sense?!?

Well, hear me out and then decide.

I was talking to a mom about her experience with a physical therapist she went to see for some hip pain. Her kids are older, so she’s definitely not in the “near postpartum” window. She never experienced any pelvic floor issues, until she tried to follow a running form cue from this physical therapist.

She tried to “fix” her form and now she has leakage when she runs!

Thankfully, that PT sent her to see me. (See? You ALWAYS need to have a referral system in place when it’s out of your scope!)

I talked to her about her symptoms and when she experienced them, and we were able to determine that trying to change her running form caused her to create more downward pressure.

We are seeing some new research about professionals being unable to reliably identify which runners are efficient and which aren’t. If we, as professionals, aren’t able to pick out which runners are efficient, should we really be telling people they are running wrong?

If we are trying to change a mom’s running form to be more “efficient”, and in doing so cause them to experience pelvic floor symptoms, is it even worth it?

Has this happened to you, as a provider or a client?

Do you think there is a right way to run or specific cueing?

Do we know as much as we think we do? Do we understand the impact on other symptoms?

August 17 2022

Does Prolapse Need to be Terrifying?

Carrie Pagliano Blog leakage, pelvic floor, pelvic floor physical thereapy, postpartum rehab, prolapse

It’s talked about the least and feared the most…

PROLAPSE.

When I have conversations with moms about prolapse, the word I hear most frequently is “fear”.

The first time I learned about prolapse was in my very first pelvic health class and the idea that organs could just exit your body…well… my mental image went to that scene in the movie Alien (you know the one).

Then, SURPRISE!

After I had my children, I experienced prolapse and prolapse symptoms (even though I had two c-sections and you’re “not supposed to” have prolapse with c-sections. 🙄)

But we don’t talk about it because we’re afraid of it. So, the mystery surrounding prolapse only exacerbates the fear.

It’s a vicious cycle.

We were taught as providers that if strengthening exercises didn’t work, then the only way to fix a prolapse was surgery.

But it’s way more complex than that!

I’ll be talking more about it here soon. I would love for other providers to share their stories with me.

Tell me about your introduction to prolapse.

Did you experience it yourself?

How do you address it now?

And moms, what was your experience of care and did it work?

How we perceive prolapse probably plays heavily into our prognosis.