Sometimes I’m wrong. I’m cool with that.
But, sometimes I’m wrong on the Internet. Guess what. I’m also cool with that. But, I do think I need to correct my wrong…on the Internet.
A while back, a blog reader commented with a question about vaginal adhesions. She was diagnosed with adhesions and was told that this is why she has painful sex. The reader wanted to know what I thought of adhesions. This is how I responded:
“So, honestly, what is a vaginal adhesion? Did you ask your therapist or bodyworker that? I just think that might be a semantics thing. I never tell my patients they have a vaginal adhesion. I tell them they have scar tissue if they have scar tissue, I say they have trigger points if they have trigger points and I say they have a contracture (really shortened, tight muscle that needs to be manually lengthened) if I think they have a contracture. Those are my honest thoughts. I don’t think a vaginal adhesion is mythological like a unicorn, but I do think it’s just a semantics issue. Of the things above that I listed, I think that internal vaginal pelvic floor physical therapy with a therapist’s finger doing the work is probably the best option – knowing what little I know about your specific case.”
Well, guess what? I was right and I was wrong.
I was correct in saying that vaginal adhesions are not mythological. But, I probably wasn’t completely correct in saying that a diagnosis of vaginal adhesions is just a “semantics” issue.
What I have since learned is that vaginal adhesions are as real as the pimples on your shoulder and as real as that $300 utility bill. They don’t always appear and a therapist can go years without seeing one, some, I dare say can go a career without ever seeing a vaginal adhesion, but they are out there. Mark my words. They are out there.
I have had three patients with vaginal adhesions now – all of whom I met after this anonymous blog commenter wrote to me. All the while I thought of her…the anonymous poster.
You: a woman reading my blog who was told you have vaginal adhesions
Me: the blog writer who jokes about it all
If you are out there, give me a sign that you read this. A comment. An email. A disparaging word. Anything. Just let me know you found me again.
Okay, so vaginal adhesions might be a semantics issue to some people who have never worked with adhesions, but for those of you who actually do have adhesions, you must know that they should be destroyed.
I learned this the scary/fun way. I had a patient whose vaginal canal was full of adhesions. It was frustrating because my finger was blocked every which way I decided to go. It was like a cobweb of road blocks. And, by the way, cobweb truly is the best way to describe adhesions. It is a webbing of very thin vascularized tissue. I could only insert my finger just past the bed of my fingernail. What’s worse was, the woman wasn’t getting any better. My futile efforts to force the finger into the furthest unknown were fruitless. I don’t do well with fruitless treatments. I don’t know if I was frustrated and treated with more force or if the hand of God just guided my own, but there came a treatment where when I removed my finger from the patient’s vaginal canal, there…was…blood.
No one ever told me there will be blood.
And there it was. Blood.
What did my neurotic ass do?
Freak the fuck out. That’s what I did.
There were apologies, questions, swearing that I’d let the doctor know right away, heart palpitations, IBS’ing all over the place, fear, tears and sweat. You don’t make a patient bleed. That’s an unspoken pelvic floor therapy rule.
I told the patient that there was blood on my glove. I told her that that had never happened before. I told her that perhaps she wasn’t getting enough estrogen into her vaginal canal (and truly, she wasn’t). She was fine though. She was cool as a cucumber, just chillin’ there watching me lose it. This did make me feel better somehow.
So I call the doctor and the doctor is pleased with the bleed. She says that the patient has tons of vaginal adhesions and I broke some and I needed to keep doing that until they were all gone.
You have no clue how relieved I was. And then I just got excited. Like, too excited.
This, for me, shifted things. I learned that vaginal adhesions don’t hurt when you break them, they just bleed because they have vasculature. They can reform again. I learned that depending on where the vaginal adhesions are attaching, they can cause pelvic pain. I also learned that 10% of women develop vaginal adhesions after mesh placement. Others develop vaginal adhesions because of vulvovaginal atrophy over time or because of medical treatments.
I learned that adhesions are out there and you can stop them.
This is now one of my favorite topics to discuss with patients, doctors, students, my husband, neighbors, the mail man, my son, my friends, the food, my pillow, my mirror, my fingers. I just love it.
If you have any questions or comments, please leave them anonymously in the comment section below or email me at Sara@Sullivanphysicaltherapy.com If you are a therapist and you’d like to subscribe to Alcove Education’s emails, just email me.