What's with the plant? Are you moving in?

Over the past year, I have arrived at my clinic hauling arm loads of home decor, books, and artificial houseplants into the back room. At first, the joke around the clinic was that I was "moving in" and my little back room in the clinic quickly became known as "Lacy's apartment." I tried to transform the perfectly lovely little PT treatment room into my own space, almost obsessively. I am the first to admit that I crave my space to feel peaceful, put together, even a little fancy by some standards because that's just how I am. However, that was never my goal in my clinic room. I just didn't want it to feel, well, "clinical."

Back circa 2009 when my name went up on the sign of the clinic! The start of my eventually becoming a Pelvic Health PT!

When you go to a medical practice complaining of a problem "down low" as I like to put it, you already feel insanely on edge. A lot of the time you have been to numerous medical offices and had to wear the dreaded paper gown while sitting naked in a cold room with shiny instruments closing in on you. I have been fortunate - I've had only one provider who has ever made me feel small and "less than" in one of these rooms, and thankfully it was unrelated to my pelvic pain issues because that would have been worse, but even with the kind physicians making you feel comfortable, you never feel comfortable, amiright? So I want my practice to be one of the places where you do feel comfortable. Or at least as comfortable as you can be when you are dealing with an issue down low.

For starters, when you come into my room, I don't want to it to remind you of all the other experiences you've had in your journey. I don't love thinking back on the room where I was told about my pelvic pain diagnosis, even though it was a pretty defining moment in my life (in a good way). It just takes me back to the other places where they kept telling me there was nothing wrong, all the poking and prodding, all the self doubt and fear. That's not what physical therapy is about.

In the back room of our beautiful clinic is my little oasis. Admittedly the paint color is a little too bright for me though it's a great color, but otherwise, it's a little place of peace for me. I have some of my favorite books there -  some about pelvic health, some about sex, even a couple of parenting books that I've accumulated. I have some succulents, some gold accents, and some art on the walls. I even begged for a purple chair so people didn't feel like they were sitting in the traditional medical office chairs. It's not perfect, but it's a reflection of me. And that's my goal. I want my patients to sit down and know ME. If they don't know me, they can't trust me. I am typically an open book when it comes to my body, my experiences in my own health journey or my pregnancy experiences. I want people who are sitting in front of me to know that there's nothing they could ask me or share with me that would make me judge them or shock me. In that room, we talk about everything from sex to menstruation, from erections to pregnancies, from motherhood or fatherhood to marriage. Pelvic health is not an island unto itself isolated from the rest of the PT world, but it's definitely a little different from "normal" outpatient orthopedics in that it's a vehicle for some pretty deep and in depth conversations that years ago I couldn't imaging having with people who were basically strangers at the time.

Of course, by the time patients are done with therapy they are no longer strangers. Often we have not only had intimate discussions but also intimate treatment sessions that involve internal work (like vaginal or rectal). Not always, but sometimes. However, I almost never start with these intimate treatments, because sometimes these are a trigger for anxiety or fear. And I get it. Because I've been there. Unless I can read that someone is eager to get moving in that direction, I typically take a few visits to work on lots of other things that are much less intimate. Internal work should NEVER be forced. It should ALWAYS be 100% okay with my patient. Period. (It's not my body that I'm working on, it's YOUR body, so YOU get the control.) There is always plenty else to do outside of that work, so we take our time. We build a relationship first, I earn their trust, and together we get to the bottom (ha, pun intended) of their issue. Always together.

Always together in the "pretty" room. Not that pelvic health is always pretty, nor is the journey through pelvic pain or incontinence, but things don't have to feel cold and sterile. It can feel softer, kinder, more relaxed, more comfortable. Treatment can be slow, it can encompass everything from the actual physical problem to the emotional implications that come with it. We talk about the guilt, the shame, the heaviness that some of these issues can bring. We talk and we make changes and we treat the person as a whole, not just pointing fingers at various organs or places and expecting things to miraculously heal by this time next week. There's no body shaming or blaming here. There's no guilt over taking two steps back or needed to shed some tears on day. That's not pelvic health. That's not good PT in itself no matter what you are doing there.

Corinne, Lacy, and Colleen renovating my kitchen soon after moving home and starting my career. These girls were my mentors first year out and came to visit me when I got home from UNC after my vagina surgery. They still mock my "waddle" that I was instructed to do when I got out of bed to use the bathroom.

We don't look so pretty here but we are genuinely enjoying each other's company. The road is sometimes full of dust and oil-based paint (that may or may not have made Colleen sick that day) but in the end, it's worth the time and effort.
Also - I took them for Exxon yogurt after this so they did get something out of it. :) 

Look, I've been in that purple chair before. I have been the patient with the tears feeling ashamed that I can't have sex with my spouse because there's something "wrong" with me. I get it. I've been the new mom, the not so new mom, the one with the crazy tear in the vagina after a vaginal birth and the one with the healing C-section scar nursing twin infants. I have been the student on the treatment table half naked while two other students who know nothing about what they are doing poke around in my vagina or rectum as they learn the new techniques to treat actual patients. I've been the one in yoga scared to do three legged dog because I don't trust my pelvic floor to keep everything in and the one at the end of the marathon with urine soaked running pants because my pelvic floor was dysfunctional. There's nothing we do in my little room that I haven't experienced on myself before. I say this not to make people uncomfortable, but to assure you that on some level, I get it. No matter what you are going through, I do get it, even if it's just a little portion of what you are going through. Every story is different. Every journey is different. Every person is different. But my goal is to make sure everyone walks out of the room feeling like they are not alone. That on some level, there's someone who gets it. Feeling confident that there are other people out there dealing with whatever it is they are dealing with, even if they may not have found them yet. Because y'all, I can assure you that whatever embarrassing physical issue you have "down low" is also being experienced by someone else right now. Probably someone you know, maybe even someone you know well. Because as I've said before NO ONE TALKS ABOUT IT.

Duke graduation, getting hooded. I was deep in my pelvic pain journey here but had the courage at the time (not realizing then that it DID take some courage) to take the Women's Health elective and start learning about how to help other women. 

But I talk about it, WE talk about it. We talk about it together with honesty, open mindedness, kindness, and grace. In the pretty room. Because when you talk about these things it should feel safe and unlike a hospital or procedure room. It's clean, it's professional, but it's different, because my hope is that you finish physical therapy and feel empowered, educated, emboldened, and that you know a place for healing that you can come back to should you need it again - this time without fear. Maybe even with a little eagerness, because Pelvic Health is just SO AWESOME y'all. I promise.


Dr. Lacy Kells PT, DPT
The Physio Down Low @ Advanced Physical Therapy Solutions
910-423-5350
lacy.kells@aptsnc.com

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