Namaste

Namaste

If you’ve been to a yoga class or two, you’ve likely heard the word “Namaste” spoken at the end of class. When I first started practicing yoga in college, I didn’t know what it meant, and honestly, it kind of freaked me out. Was it an incantation for some foreign deity? Was I invoking a spirit? Nope. It’s neither. It is a Sanskrit word that translates roughly to “The divine in me honors the divine in you.” Some use the word “light” or “teacher” in place of divine, and I think they all make sense. The phrase is simply an acknowledgement that there is a piece of divinity (call it God, Spirit, or what you will) in each and every one of us.

When I became a PT I thought I would go out and change people’s lives. I like to believe I do that, but I didn’t expect my patients to change me the way they have. I have learned SO MUCH from all the individuals I have touched and taught over the past decade. They have helped mold my view of the healthcare system, the human body, “evidence-based medicine” and alternative (or “woo”) approaches to healing. They have given me tips on marriage, on family, transformed my view on what it means to be a mother and a woman, and given me confidence in my vocation.

Considering all that, I’m not quite sure why I was surprised to find the same thing when I started teaching yoga. Teaching a room full of students has in turn taught me how to be a better teacher. Perhaps it is each individual over the years that has taught me so much, or perhaps it is that spark of light, of divinity, that common thread that is in each of us, that is teaching us all the time. We just have to look for it. It’s there. And it’s quite easy to find if you are aware.

I now end my classes as I’ll end this post: “The teacher in me honors and sees the teacher in each of you. Namaste.” 

Yoga for Menstrual Cramps

I don’t know about you, but my periods have never been fun. I remember as a teenager being late to school because I was throwing up, my cramps were so bad. Once I was at camp and didn’t bring ibuprofen; the camp nurse would only give me one Tylenol every 6 hours. Needless to say, that did not cut it. I remember spending 3 miserable days with my head on the table in the Craft Shack, just wishing time would move faster.

It’s become more manageable over time, with the help of naturopaths and acupuncture and becoming more embodied. At times I have practiced gratitude for my bleeding, for the incredible way my body cleans itself out each month, and it actually made it pleasant (thanks to Tami Lynn Kent’s Wild Feminine for that inspiration). Then as I entered the world of TTC (trying to conceive) and subfertility, that became a little harder to do. It’s like insult to injury to be bleeding AND have cramps, when I am working so hard to just be pregnant.

But I digress! This post is NOT just a complaint against Aunt Flow. I do think she’s lovely, even when she feels like an unwanted guest. I want to share something that has helped me over the years to manage the discomfort during my moon-time: malasana.

I can’t tell you the exact mechanism of relief, but I can tell you it’s an excellent posture for relaxation of the pelvic floor, especially if you focus on releasing tension. Imagine your sitbones moving apart. Or your tailbone moving backward, even “wagging.” This is the first thing I recommend for my patients with pelvic or tailbone pain, too. And of course, it’s an excellent position for laboring (though not so hot for actual delivery since it’s correlated with an increased risk of tearing!).

The basic movement is simply a squat: heels down, butt down. I use my elbows with hands in prayer to push my knees apart and give more stability. Other options include having a block or bolster under your bum, having something under your heels if you have short calves, leaning against a wall, or leaning back while holding on to something stable like a doorway or sturdy table leg. Then just hang out. The more supported you are, the more you can relax your pelvic floor. Then, ahhh.

What tricks have you found to manage menstrual cramps? I’m always looking for more tips!

Pelvic Organ Prolapse (Part 1)

Let’s talk about pelvic organ prolapse. You might call it a heavy feeling, or a bulge, or say it feels like there’s a “golf ball in your vagina.” You might feel something when you wipe, or you might think stuff is going to fall out. I’ve had more than one woman tell me her vagina is falling out. Oofda.

 Well what’s going on? First of all, don’t worry: your organs ARE NOT falling out. I always say I can fix a prolapse 50% in one visit by just telling my patients that fact. Did I change where their organs are sitting in their body? Nope. But I affected their perception, gave some peace of mind.

Prolapse occurs when one or more of the pelvic organs (bladder, rectum, or uterus) drop lower in the pelvic cavity due to a decrease in support. All of these organs are “suspended” inside the pelvic cavity by ligaments around the uterus. From below, they are supported by the pelvic floor, like a hammock. During pregnancy, these ligaments obviously stretch A LOT. In the most perfect vaginal delivery, the pelvic floor also stretches A LOT. Even with a cesarean birth, the ligaments still stretch, so it doesn’t necessarily prevent prolapse.

As I said before, it often feels like a heaviness or bulge in the vagina. Many women feel this immediately postpartum, then it gets better over the first several weeks. Some women notice it all the time, while others don’t notice it at all. Some feel it more after a workout or a long walk. Sometimes it goes away completely when they lie down. Sometimes it interferes with sex, causes urinary leakage, or causes constipation.

The good thing about prolapse? It’s not going to harm you. As professionals in this area, we care more about how much it BOTHERS you than how severe the prolapse looks objectively. Which is why I can fix one 50% in one visit ;). It’s all about perception. No good doctor should recommend surgery if you aren’t complaining about how it feels.

How is it treated? Start with physical therapy. We can’t necessarily tighten ligaments from above, but we can sure work on strengthening the pelvic floor to improve support, provide manual techniques to optimize organ position, and teach you strategies to minimize discomfort. And we can keep reminding you that nothing’s going to fall out. ;)

About Insurance

Let’s talk about insurance.

I am an out of network provider. I do not contract with any insurance companies, and patients pay me directly at the time of service. In turn I provide them with a “superbill” which they can submit to their insurance to be reimbursed directly.

Here is why I chose this route:

I have never liked people telling me what to do without good reason. Ask my parents, teachers, and past bosses and they’ll tell you this is true. Some might call it stubborn, but I consider it self-advocacy.

When I started my practice, I had to decide if I wanted to take insurance or not. The first question a prospective patient asks is “Do you take my insurance?” If I answer yes, I have removed one barrier. However, taking insurance often creates more barriers:

-Many insurances require a referral for PT, which means one more appointment to make and get to, adding an unnecessary barrier. Most of my patients are busy moms—it’s enough to ask them to make an appointment with ME, where they’ll actually get some help! Having a visit simply to get a referral does nothing to actually help an individual, and the runaround often is enough to make a gal give up seeking the help she needs.

-Some limit the number of visits they’ll cover based on algorithms instead of your unique person and situation. It’s fairly common to see insurance approve “6 visits in 3 weeks.” This is fine for an ankle sprain, but for someone dealing with incontinence or painful sex for a decade, it really just doesn’t cut it.

-Some won’t pay until you hit your deductible, which can be upwards of $5,000. I’ve had patients complete several visits before getting a bill in the mail, only to realize none of it was being covered because they hadn’t met their deductible.

-They all require an absurd amount of administrative time for the provider. As a one-woman show, I believe my time is time better spent on providing excellent patient care. It’s what I’m good at. And really, that’s what you are paying for. 

Like I said, I don’t like other people telling me what to do, and I don’t want anyone telling me how to treat my patients. Ultimately, I believe this relationship is between you and me, and a third party shouldn’t be telling me how much I can treat you or how much your care is worth. I work for you, not your insurance. I want you to know the value of what you are paying for, no surprises.

Our healthcare system is broken—I don’t have to tell you that. It is too broken for one person to come along and fix it. I believe we all need to be our own self-advocates. The first step to doing that is to understand the coverage that you have individually. Often, it’s not as comfortable as we thought it was.

I encourage all of you to know your coverage. Don’t know where to start? Here is a list of questions to ask your insurance company. Keep asking questions until you REALLY understand your coverage. Keep advocating for yourself and your family.