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Amy Medley has a touchy job. She talks about subjects that few people want to broach.
“I tell people I treat pee, poop and sexual dysfunctions,” said Medley, who has been with Methodist Hospital five years. Her patients range in age from 20-80 years old. “There’s not an average age because it’s so skewed in both directions – it kind of depends on the diagnosis,” she said.
Typically, her patients come to her with issues that range from pain during sexual intercourse to bladder leakage, and are referred to her by urologists, colorectal and gastrointestinal surgeons, and obstetrician/gynecologists.
“By the time they come to physical therapy they have ruled out things that omit surgery. Most of the time it comes down to a muscular function that controls the bowel or bladder. It’s not something related to a spinal cord injury or neurology. So therapy and muscle exercises are needed,” said Medley, who turns 34 next month.
The American Physical Therapy Association chose October as the month to celebrate the impact of physical therapists and physical therapist assistants. And Medley is on board when it comes to talking about issues that may not be in the forefront of the profession.
The area of pelvic floor dysfunction is not new, but talking about it openly and seeking physical therapy is relatively new, said Medley.
The pelvic floor is a group of muscles in the pelvic area that support the organs in the pelvis – including the bladder, uterus (women), prostate (men), and rectum. By contracting and relaxing these muscles, individuals control bowel and bladder movements. Pelvic floor dysfunction occurs when individuals are unable to control the muscles in the pelvic floor. Symptoms may include feeling the need to have several bowel movements during a short period of time, or inability to complete a bowel movement, constipation, frequent need to urinate, painful urination, lower back pain, ongoing pain in the pelvic region genitals or rectum, or, for women, pain during intercourse.
Symptoms are often talked about with products that help patients mask the dysfunction but not how to treat it. That’s one of the reasons Medley is open about her work and passionate about the therapy.
“My fear is there are products that say it’s ok to leak, but it’s not ok. We can do something about it. Thankfully it’s being talked about in a way that normalizes it,” said Medley, who obtained an undergraduate degree in business and uses that background to promote physical therapy. “People are talking about it more. I’ve spent a lot of time educating healthcare providers and making them aware that there are ways to treat this.”
When she speaks publicly, Medley is open and honest. She includes in her presentation a clip from the 1995 movie, “Billy Madison” where Adam Sandler declares: “You ain’t cool unless you pee your pants.”
She uses the same candid approach with patients: “I tell them, it’s not OK to pee your pants. We can help you. It’s about communicating openly. Sometimes we use our sense of humor but the main thing is they should know we are talking about professional topics and it might be uncomfortable, but they shouldn’t be embarrassed.”
In treatment, Melody, the mother of two children – ages 9 and 4 – incorporates props - soft plush toys shaped like organs, and a model of a plastic uterus - when explaining symptoms and therapy.
“The treatment is individualized because there’s not a cookie-cutter plan for everyone whether we are treating the shoulder or another body part,” said Melody. “It’s also based on their goals. If they want to bend over and pick up their grandkids without leaking, then we work toward that.
“I try to make it as functional as possible because I want it to be something they’ll stick with,” said Melody. “It may be as simple as an exercise they can do while brushing their teeth or climbing the stairs. The goal is to empower them to go home and work on caring for themselves.”
-- By T.J. Banes, Associate Senior Journalist at IU Health.
Reach Banes via email at T.J. Banes or on Twitter @tjbanes.