After some chit-chat and a brief physical history, the Physical Therapist did a vaginal exam, because that's the best way to get to the pelvic floor. She slid a finger up my vagina and immediately announced, "I know EXACTLY what your problem is."
Then she kept her finger up there while she explained she felt just a hard wall of knotted muscles. I joked, "I carry my tension in my vagina" and she replied, seriously, that I was entirely right. I have a spastic set of pelvic floor muscles. I was skeptical, of course, until she began to do some (" ... fisting?" Gary asked later) ... some myofascial release message on the muscles. It hurt like hell until eventually it got to the point when, frankly, I felt suddenly that I was in the process of having a particularly successful bowel movement.
"You probably feel like you're having a bowel movement right now," she said, "That's because the only time these pelvic floor muscles have been relaxed is when that's happening. After a few sessions and some relaxation exercises on your own you won't associate pelvic muscle relaxation with your bowels."
So, that sold me, even before she hooked me up to the device. It seems she was pretty sure of the diagnosis before she poked me, because I had the trifecta: complaints about all three organs surrounded by the pelvic floor muscle. Bowel issues, bladder issues, and I have never mentioned it but did you know the first five minutes of sex isn't supposed to be painful? It isn't! Gary and I always assumed it was because it had been a week or so since the last time and I had closed up or something. His only other "point of comparison" .... well, she drank a LOT of wine.
She had me do a Kegel, complimented me on my contraction, and told me to "let go." It finally occurred to me to ask: I could see how having a tense pelvic floor would make me constipated, would make the first few minutes of sex painful, "but why would having a partially clenched shut muscle make me urinate on myself?
She answered, "I'm pretty sure I know why, but let's bring out the biofeedback device."
"Yes!" I said, "I will break your device! I will ring the bell."
"I could set it up to have a bell. But let's see how you do just with the meter."
She hooked the electrodes to my pelvis and I gave her the Kegel Of My Life.
Ten out of SIXTY.
"Very good," she said, as I wailed and pointed to the top of the scale.
She said, "I don't know why it goes up to sixty. Ten is good. The highest I've ever seen anyone get it was a teenager who got it almost to 20. Besides, here's your problem, look at this. Your resting state bounces between three and four, and never gets to zero. It's bouncing like your arms would shake if you had to hold something up a long time."
Then we started with the analogies. My pelvic floor muscles are like: a lightbulb sapping all the electricity, an elevator, a violin string, a car already going top speed, and a baseball pitcher. Or, as I volunteered, Terry Schiavo pitching baseball. It would seem that since I can't relax and get down to zero, I can't call on my resources fully when I need them. (Compare a relaxed baseball pitcher with Terry Schiavo. Doesn't matter how compressed her muscles are, you have to have them relaxed at some point to function.)
So, I could NOT play the lower notes on the concertina even if it was correctly positioned up inside me. Just a bunch of short high squeaky fast notes. And I would get tired quickly.
Still, I thought, even if my pelvis is exhausted from the constant energy drain of flexing, it can still get up to 10. That's probably why I can hold it in during a sneeze or a cough.
I asked if I got it down to zero and conserved my energy until I needed it, coud I snap it shut at 12 if I choked on something again. (Actually, zero to 15 is my new goal, but that's personal. I didn't tell her that.)
She said, "I don't know. You're the first person who has complained about choking; we'll have to see. But we need to fix this for another reason; you're at risk for the central nervous system MS urinary retention issues, and you don't want another reason for retention. If all the urine can't get past the semi-clenched pelvic floor, there will be a little left inside, and that may come out later as dribbles."
"But I don't dribble now." I said.
"The same goes with your bowel," she said delicately, and I said "OOoooo." I thought I'd been turning into a teenage boy, the skidmarks were becoming so prevalent.
Then I said, proudly, "But, since I know I'm prone to retain urine, I always strain a little to get the extra urine out."
And then we began the part of the visit titled The Worst Things You Can Do.
Don't strain ever, for anything, don't push against your pelvic floor. Then she added, "There's a condition called uterine prolapse -" and I crossed myself. No more straining.
Oh, and my clever idea of urinating every two hours? Also the Worst Thing I Could Do. Always every three to four hours, even if I feel like I possibly could go earlier.
Wearing pads? Also not great during physical therapy, because they mask dribbling problems one might have.
So, I got my List of What Not To Do, some Pelvic Relaxation Exercises To Do, and a plan for continued Physical Therapy in Which She Places Her Finger Inside Me ... (and masturbates you? Gary asked later) ... and works on releasing knots in my pelvic floor.
"So, could you teach Gary how to do this?"
"Well, I could, but I don't think we'll need to, you should get relaxed in a few weeks. Actually, right now Gary probably thinks, 'Awesome, it's like I'm having sex with a twenty year old.'"
(Gary protested later he never did get a chance to have sex with a twenty year old, since I wasn't putting out at twenty, so he wouldn't know.)
I answered, "No, he doesn't appreciate it at all. He says it's too much effort to have sex with me." (While it was insulting at the time, it makes more sense now.) "He also thinks I have gained weight inside my vagina."
"That's ridiculous. You can't gain weight inside your vagina." She also shot down Gary's suggestion my weight or lack of tone contributes to this. So, I like this woman, and what she says makes sense.
Today, I have been trying very hard to achieve that satisfying mid-poop sensation the rest of you feel all the time (along with the completely painless sex you have). I'm looking forward to the next Deep, DEEP Swedish massage. Until then I will do my exercises, keep my Number One diary, and try to relax down there.