"No surgery is better than a bad surgery"

-Dr. Teresa Hilgers

Looking for a surgeon for PCOS, pelvic pain/endometriosis, and/or infertility and don't know where to start? Understand that not all surgeons have the same training and expertise? Do you need a repeat surgery? Unsure of questions to ask when interviewing surgeons? Have you heard of plastic surgery for the pelvis?!

This episode is for you. Mary interviewed one of her best friends, Lisa, who is an experienced nurse and Certified Creighton Practitioner. They shared their years of experience personally and professionally, following clients before they had surgery with a variety of different surgeons and afterwards to assess outcomes. Lisa shared some fascinating and provocative information she learned recently at the Annual FertilityCare Conference from surgeons and researchers to give you all the information you need to make the best decision for yourself.

Anti-Adhesion Research:

A video that explains Pelvioplasty:

Did you know that almost any physical therapist can call themselves a pelvic floor physical therapist, but not all are equally equipped?

In this short bonus episode, Mary interviewed Dr. Jenny Porter, a physical therapist who specializes in pelvic floor, to learn what qualifies physical therapists to treat different pelvic floor issues. How can you know whether or not your PT is equipped to help you?

1. Physical Therapy is a doctoral degree that takes 6-7 years to complete. Less than two hours is spent on the pelvic floor during that entire time.

2. Specific continuing ed courses are required to gain expertise in treating the pelvic floor.

3. Herman and Wallace and APTA are companies that offer the best/standard training courses for physical therapists who plan to treat the pelvic floor.

4. Level 2 training is required to treat sexual dysfunction, and postpartum, bowel, and male issues. Level 3 is required for the complicated neurological and congenital issues.

5. Your pelvic floor physical therapist (PFPT) that is equipped to treat you for sexual dysfunction is not necessarily qualified to treat you during pregnancy/postpartum, and visa versa.

6. Almost any physical therapist can claim that they are a pelvic floor physical therapist. There is no regulating body for PFPT yet - only physical therapy.

Listen to the episode to hear the questions Dr. Jenny Porter asks other pelvic floor PT offices to figure out if they are qualified to treat specific issues and for Jenny's tips on how to find help if you don't have the right kind of PT near you.

You can find Dr. Jenny Porter at Pivotal PT & Wellness in Mandeville, Louisiana.

Previous podcast episode interviews with pelvic floor physical therapists:

Co-host of the Hormone Genius Podcast, founder of the Fiat Institute, and Creighton Practitioner, Jamie Rathjen, M.A., FCP joined Emily and Mary to explore her new (and pretty amazing) hormone coaching program, which fills the gap between your fertility awareness instructor and your physician. There are lifestyle factors and nutritional insights that these pros just don't have the time, or knowledge in many cases, to address. This is where your hormone coach comes in! So far, Jamie has trained about 30 incredible women (a mix of Creighton & FEMM instructors, PAs, DOs) to serve you in this space! Jamie also explained how stats on birth control influenced her work.

Find Jamie: www.hormonegenius.com, www.fiatinstitute.com, www.guidingstarproject.com

Instagram: @fiat_institute, @hormonegenius

To become a hormone coach: Fiatinstitute.com

To receive hormone coaching: email [email protected] or visit Fiatinstitute.com/directory

Charting for Mary had really good moments. Her Creighton chart revealed a lot about what was going on in her body and that was really helpful to her physicians and for her to understand some pretty intricate details about her health. However, because it revealed how dysfunctional her body was and trended worse over time, it got really hard. The meds, supplements, and doc appointments got hard, too. Pregnancy tests really messed with her mind, but you'll learn in this episode why she had to continue to take them.

Is there a healthier way to approach charting? Restorative reproductive medicine? Our relationship with infertility? Why doesn't pregnancy heal the wounds of infertility? Emily interviews Mary to find out.

Mentioned in this episode:

So you've found our amazing website at fabmbase.org, but you're also feeling like there is a ton of info. Where do you start? Keep your eyes peeled for a series of bonus episodes that will help you to maximize your time navigating our website and get the most out of it for your individual needs.

This first one will help you or someone you know to use our website to find the method that fits best (there are two ways!!), get all relevant info to help you access the method websites and materials you'll need, and find solidarity!

WATCH and listen to this episode on YouTube so you can see how Mary navigates the website with her shared screen as she explains each detail.

⁠⁠Fabmbase.org⁠

Well, it's no secret that we have a deep appreciation for the benefits of charting our cycles, but let's be real - sometimes it just sucks! Charting is more than putting marks on the paper or app and making observations. It has an effect on life and life has an effect on it and Emily's story illustrates this really well.

In this episode, Mary interviews Emily about her expectations about sex going into marriage, how that played out, the pressure of needing to avoid a pregnancy, sharing the responsibility, the mental health importance of finding the right method for each individual woman, and when Emily wanted to stop charting.

One of the biggest struggles for infertile women is how to navigate a wide range of emotions around close friends and family members. Many women who haven't personally experienced infertility have the same concerns and want to know how they can care for their loved ones' hearts. How do I share my pregnancy with her? How will I manage being around friends and family with pregnancies? How can I show her I care? Emily and Mary understand how difficult this can be because they have personally experienced it in their friendship, and sort of accidentally discovered how to do it well. Tune into this episode to learn how.

Discussed in this episode:

Dr. Jenny Porter is a physical therapist at Pivotal PT & Wellness in Mandeville, Louisiana, specializing in pelvic floor therapy for men, women, and children with bladder, bowel, sexual, and pain dysfunctions. This episode was dedicated to bringing awareness to what it means to have a normally functioning pelvic floor.

Here is some of what was discussed:

-A normal pelvic floor vs changes identified that cause pain

-What causes pain with intercourse? What is vaginismus? What about postpartum?

-The range of pain intensities possible (mild, moderate, severe)

-Should a tampon ever hurt? An OB/GYN visit?

-Can my husband be "too big?"

-Should I bring my teen, or even younger daughter to pelvic floor PT if she has pelvic pain?

-How does endometriosis cause painful sex? Why do I still have pain after surgery?

-What does treatment look like? How long can it take?

-What is a dilator and do I have to use one? Is this licit?

-If I have tightness/painful intercourse, does this increase my risk of tearing during labor?

Mary shares a bit about her personal experience with pelvic floor tightness, painful intercourse, and pelvic floor physical therapy. Since Jenny is her PT, they were able to offer a unique perspective of these situations. This is an honest conversation about the most intimate parts of a woman’s body. We know that this can be a sensitive subject, and please know that we did our best to handle it with care. We won’t shy away from these difficult conversations because we believe they are important and often do lead to healing.

Links mentioned in the episode:

S1 E3: Pelvic Floor Physical Therapy with Drs. Emily and Jenny by The Intersect: The Official Podcast of FAbM Base (anchor.fm)

Dynamix PT & Wellness - Physical Therapy, Dry Needling (pivotalptandwellness.com)

Emily Jurschak is an orthopedic and pelvic floor physical therapist located in Alexandria, VA. She owns and operates her own private physical therapy practice, Fiat Physical Therapy. Emily is a board-certified orthopedic clinical specialist who emphasizes the importance of integrating the whole person into her treatment and plan of care, and loves teaching women about their bodies.

Emily Frase sat down one-on-one with Emily Jurschak for an indepth conversation around prenatal and postpartum pelvic floor physical therapy. Jurschak kicked things off with a fascinating explanation of the function of the pelvic floor as it relates to pregnancy and postpartum (which you may want to watch on our YouTube channel), which gave great context to answering questions like when to start PT whether during or after pregnancy, and how C section scar massage is beneficial. Frase also shared her own experiences during pregnancy and birth. The two Emilys also shared the importance of gentleness and mind-body connection through these two wildly changing periods in a woman’s life.

And you’ll want to listen all the way to the end of the episode - Jurschak shares the most common issue she tends to treat for both pregnant and postpartum women.

Whether you’ve have or are planning to get pregnant soon, no matter if you’ve had vaginal or C section deliveries, this is an episode you won’t want to miss!

Resources mentioned in this episode:

Find out more about Emily and her practice. Find her on Instagram @FiatPhysicalTherapy

Search our External Resources page for ways to find pelvic floor PTs near you. 

Check out the first pelvic floor PT episode we shared here on The Intersect, Episode 3 with Drs. Emily and Jenny on your favorite podcast app. 

We couldn't finish up our Sexpisode series without giving some very real examples of how these ideologies can be brought to life, and often without us realizing it. Emily divulges about how purity culture has affected her relationship with her body image. Mary shares how one aspect of purity culture did some huge damage to her understanding (or lack thereof) of sex and how it is still having a pretty big impact on her and her marriage. Since it isn't always easy to see, we explain how damaging it is to insist that NFP can be used with a contraceptive mentality specifically for those who are infertile. 

Mary and Emily get pretty vulnerable in this episode. Don't miss the conclusion of this special series and please don't forget to rate this podcast/leave a review!