Friday, April 30, 2010

Pelvic Floor Muscles and Pain-Not gender specific


Pelvic pain can be from many causes such as, vulvodynia, irritable bladder, infection, interstitial cystitis, vaginal atrophy, prostate problems/pain, and last but certainly not least, myofascial trigger points. fibromyalgia (FM) and chronic myofascial pain (CMP) from myofascial trigger points, AKA myofascial pain syndrome (MPS) often co-exist.

Fibromyalgia (FM) and Chronic Myofascial Pain (CMP)

FM and CMP often co-exist. CMP from myofascial trigger points is a peripheral nerve to muscle problem and FM is a central nervous system problem. When they co-exist, the peripheral message of painful trigger points to the brain of an FM patient keeps the brain in a hypersensitive state," causing a “wind up” phenomenon at the HPA-axis (dysfunctional in FM). If you have both, it bloodies the diagnostic waters and most importantly delays appropriate treatments.

The function and discription of pelvic floor muscles
The muscles in the pelvic floor are what keep your organs from falling to the floor. There is the perineum, the urogenital triangle, the anal triangle. These muscle systems support the rectum, the vagina/penis, and the urethra.

Symptoms and therapy

Pelvic floor trigger points symptoms can include, pain in the genitals, perineum, bladder, vulva, urethra, prostate, tailbone, vagina, rectum and even the low back and groin. Trigger points can cause sexual dysfunction, painful intercourse, menstrual pain, and impotence. A pelvic floor therapist is specialized physical therapists will treat these with electo-stimulation, and teach you how to do pressure therapy with tennis balls and such at home. I am a firm believer that women should see a gynecological urologist, just like children should see a pediatrician. But make no mistake, if you are a man reading this, trigger points can be present in your pelvic floor too, with its own host of complications as previously mentioned, including erectile dysfunction.

If you have trigger points in this area, you most likely have them elsewhere. Myofascial trigger points can mimic many things and cause pain, dysfunction, and shortening of the muscle affected by this knotted up muscle fiber in a taut band of muscle. Such things as paresthesia (numbness and tingling), if located next to a nerve, circulation/temp changes (if located next to a blood vessel) and swelling (if located next to a blood or lymph vessel) may also be present. It is possible that TrPs in the pelvic floor could be satellites of a primary TrP located in muscles that refer pain to the area. A good trigger point manual will help you determine referral patterns of TrPs. You can search Amazon or Barnes and Nobel for books by Clair Davies and Hal Blatman.

Seldom are doctors well informed about myofascial pain and trigger points, no surprise I am sure. All they have to do is go to pubmed and search trigger points (TrPs) to see the research. Newer research suggests that it may be present in all FM patients, though CMP is not always accompanied by FM, making the two distinct disorders.

Of course rule out other problems as suggested. You will be able to feel the pea sized knotted up TrP in a taut band of muscle unless the muscle is too hard, beneath another muscle or bone or even in the vaginal vault (in which case you may have to have your mate help you locate them. If the trigger point (TrP) is active you will have pain in the pelvic floor muscle affected and in the referral pattern. If the TrP is latent (meaning present but only hurts when you sit on it), it is just as important to treat it. Sit on a tennis ball and find the area of discomfort. Apply pressure with your weight to maximum discomfort, then back off to about 70% (so blood can still get to the TrP) and keep pressure for about 30-60 seconds. Follow up with a gentle stretch of the muscle using your fingers.


An ounce of prevention is worth a pound of cure. Once you are able to get the TrPs under control, pay attention to aggravating conditions. Those that come to mind are poor posture, pants that are too tight, and a chair that does not provide adequate support.

Always rule out other cause of pelvic pain and discuss your symptoms with your doctor. If your pain and dysfunction is not found to be from another source, please look for those myofascial trigger points, they are treatable.

(Signature line appended, March 2018)

In healing,
Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All blogs and comments are based on the author's opinions and are not meant to replace medical advice.  

Monday, April 26, 2010

Sugar Sweetie?

Did you know sugar could be aggravating your FM, CFID of CMP? I discuss this extensively, because it is a great perpetuator of many things.

In the book, I address sugar toxicity directly related to FM, CFID and the trigger points of CMP. High glycemic sugar intake can cause a host of problems, in addition to brain fog, it can also cause… (from the book, copyrighed material)

...There are other reasons for this that will be discussed later, but understand that excessive sugar and carbohydrate intake have been linked to a higher risk of developing yeast overgrowth."

"Leaky gut syndrome
....Treatment, includes restoring the gut’s friendly acidophilus bacteria,restricting foods with chemical preservatives, avoiding alcohol, ingesting fiber and magnesium to speed intestinal motility, avoiding NSAIDS (nonsteroidal anti-inflammatory medications) that upset the intestinal lining, limiting caffeine and yeast products, and avoiding sugar and saturated fats."

The IgG, IgA, and IgM antibodies tests can be used to check for candidiasis-initiated responses.

What are important things to consider? (excerpts)

"Managing Your Diet.
...The way food is converted, used, and stored depends upon the body’s metabolism. Sugar and complex carbohydrates trigger insulin release from the pancreas into the blood. Insulin plays a major role in carbohydrate metabolism and helps regulate the way our bodies utilize carbohydrates, lipids (fats)"

"What We Eat.
..Learning how certain foods correlate with your symptoms will help you learn how to adjust your diet to eliminate aggravating foods. Minimizing use of sugar and saturated fat will help you feel better. Sugar is known to stimulate the growth of microflora in the digestive tract, such as the dreaded candida (yeast). It also generates free radicals and raises insulin production. And fat? Well . . . fat is difficult to digest! It clings to the inside of blood vessels and the outside of hips.".......
....."Diets that are higher in monounsaturated fatty acids, fiber, and low glycemic index foods appear to have advantages in insulin resistance, blood glucose control, and circulating lipids (fats).".......
.....".As previously noted, insulin, a protein hormone, is important to cellular metabolism. It helps the body regulate energy. Insulin resistance happens when your body no longer responds appropriately to insulin. Changes in your diet may help with the side effects of brain fog, the aggravated TrPs of CMP, fatigue, tremors, palpitations, anxiety, sweating, and hunger. Paresthesias and more serious symptoms, like seizure or coma, may result from insufficient brain glucose (sugar). Excessive insulin production prevents carbohydrates from being utilized for cellular energy, and some people can tolerate very low levels of blood sugar without the usual warning symptoms.100 In some cases, insulin resistance can lead to RHG.".......

Reactive hypoglycemia
...Reactive hypoglycemia may accompany FM and CMP in a certain subset
of patients, and may lead to insulin resistance...

(This is a double edged sword, related to simple suger and high glycemic intake)

......."According to Dr. Starlanyl, RHG is a type of hypoglycemia “that is specific to low blood sugar and occurs in response to a high carbohydrate intake.” This is not the same as hypoglycemia (low blood sugar) from not eating.

In the case of RHG, the body overreacts two to three hours after a highcarbohydrate meal, causing excessive insulin production that significantly lowers the blood sugar."...

..."When you add a protein to every meal or snack, you decrease the risk of surges in blood sugar and insulin production. This can be particularly helpful in relieving symptoms of hypoglycemia."

"What is a Balanced Diet?.....
Limit intake of free sugars, such as simple sugar and refined sugars from cane, beet and corn (high fructose corn syrup), and sugars found naturally in honey, syrups, and fruit juices."

I hope this "look between the pages" stirs an interest in learning about the importance of managing your sugar intake.

As always, Lamb hugs

Saturday, April 24, 2010

Significant Others

I swear Jeff wrote this one for the book because he knows my husband. Here’s one of the excerpts.

• The Drill Sergeant assumes you need a couple of swift kicks in the derriere
to “get over” the condition. This person says, “Buck up” and “Don’t
complain.” Usually this is the person who would whine first, if faced with
our challenges.

Yoga and T'ai Chi

T'ai Chi

Science has shown t’ai chi is beneficial for FM and CFID, and it helps maintain muscle health of well-tended TrPs (trigger points). Because of the focused movement,
the mind focuses away from pain. Stretching tender, contracted muscles helps the FM patient maintain flexibility and minimizes any coexisting tendonitis and bursitis. Even CFID patients should be able to tolerate this low level of activity without triggering a flare. Of course, if you are in a flare, any activity should be minimized until your body has a chance to regroup.

Tai chi is very gentle stretching for tender, contracted muscles. It helps the FM patient maintain flexibility and minimizes any coexisting tendonitis and bursitis. Even CFID patients should be able to tolerate this low level of movement without triggering a flare. Of course, if you are in a flare, any activity should be minimized until your body has a chance to regroup.


Book Excerpt (protected by copyright)

The most familiar forms of yoga involve gentle
movement and regular breathing exercises. Some yoga practices also include
visualization, progressive relaxation, and meditation. By assuming various
yoga positions (asanas) and practicing controlled breathing, it’s possible to
achieve an altered state of mind and increase oxygen and blood flow to the
body’s organs. Yoga also promotes alignment of the spine by improving flexibility.
Many practitioners believe it purifies the body of impurities by harmonious
regulation of the endocrine and nervous systems.

If you have FM or CFID and CMP from Myofascial Trigger Points

Research shows that once you bring myofascial trigger points under control, it is important to maintain the muscle tissue. As I say in the book, yoga provides a good stretch, but holding postures can activate dormant/latent trigger points. I do the yoga postures in the book, but I do them with fluid movement from one to another, no holding. I also do T'ai Chi, the rhythmic movement is good for the muscles, the brain, arthritis, mindfulness, and many other things. I am addicted to Tai Chi. If I can't do it, I get nervous.

Lamb hugs

Poetry - Inner Expression for Coping with Pain & Fatigue

Coping with chronic pain is challenging. Maintaining forward momentum in the face of unpredictable symptoms and fatigue is daunting. Dealing with brainfog is frustrating.

Poetry is a the conduit to our soul, providing energy to hurtle over the many obstacles we meet in life. It provides an endless path by heightening our senses, sight, sound, touch and smell. It is the feel of texture, and all that is not present but is in the mind and knows no time, but is expressed in words. It is inner beauty, the wits, the connection to ourselves.

Exploring Your Creative Nature

Writing a poem is your work, you are probably the only one that truly understands the meaning of your words, and the added attraction is the energy it creates in getting to know you. I cannot quote a poem I have written, but I can tell you how I was feeling when I wrote the poem. I reconnect with that feeling when I revisit those words. It’s like hearing the chorus of an old song, even though you might not recall all the words, you connect with the feeling during that time in your life.

Poetry is writing about yourself waiting to see what will show up, the words are the finger points of your soul.”
-Sandford Lyne, Author of, Writing Poetry from the Inside Out

Friday, April 23, 2010

Sample Advocacy Letter

You can use the sample letter below as a model for personal advocacy letters
to send to elected representatives, members of health commissions, hospital
directors, health care providers, or anyone else in a position to affect health
care policy.

Organization name

Dear Gentlemen and Gentlewomen,

[State the purpose of your letter. Start with a hook, such as,]

Did you know that a tick bite or an infection could alter your life forever? Did you know that as a result of something you had no control over, you will be labeled as a whiner, a weak person, lazy, all because you received a diagnosis of chronic fatigue syndrome?


What if you couldn’t remember your best friend’s name, or every time you tried to get a point across you spoke in a language even you didn’t understand. What if you were holding a pen in your hand and you forgot what it was for? This is the brainfog that robs people with fibromyalgia and chronic fatigue syndrome and it occurs without warning.


What if you were experiencing severe muscle pain and dysfunction and you could feel the knotted up muscle fibers in a taut band of your muscle, but your doctor wouldn’t even take the time to put his hands on you, or worse yet, he/she did and doesn’t know what this means.

[ Make it personal. State your personal experience with your disorder and how it
has affected your quality of life. Include the onset, your symptoms, and how you have
been physically and emotionally treated. Then state what you would like in response.]

[Provide the opportunity for follow-up, such as,]

If I can provide you with further information regarding these disorders, I
would be happy to do so. Please contact me at [List your full name, address, and
any other information you feel comfortable giving out, such as e-mail address, phone
number, or fax.]

Signature [Type or sign your name here.]
Attachments: [Name any attachments that support your letter and its content.]


Moving to mainstream

Things are a chang’in as we learn more about these disorders. The presence of XMRV antibodies in CFS patients and the few FM patients tested unofficially at Whittemore Peterson Institute (The study on CFS published was published in the prestigious "Science") is an example of that. The fact that Dr. OZ is actually saying the words, FM, CFS and XMRV and CMP on TV is also exhilarating news. We must keep an open mind to the many possibilities that are ahead. If I know anything as a medical person, RN, it is that science is in perpetual motion which means change. We cannot take one notion, study or person, including myself, as the Holy Grail until we really know the cause. Thanks to the many dedicated scientists and doctors I believe the answers will be coming. The most important thing we can do is advocate for funding so the necessary science can take place.

Knowledge – Empowerment

When we empower ourselves with knowledge, not even the most least compassionate health care provider can take it away. Not even one iota of what we have learned the hard way. Mark my words, "they will be eating crow one day," maybe sooner than we think. The evidence is staggering now and we have come a long way. Hold on tight, it's going to be quite a ride.

"Never doubt that a small group of thoughtful, concerned citizens can change world. Indeed it is the only thing that ever has."
--Margaret Mead

About The Book

The book answers questions like:
How can I be more than a bystander in my own medical care and why is proper documentation in my medical record important?
How are FM, CFID and CMP different, how do they cross over and why should I know?
How do I communicate my needs and symptoms successfully?
Where is that word I had two seconds ago?
What will help me deal with this brainfog?
Why do some treatments make me worse when everyone swears they will make me better? What should I look for in the “right” doctor?
What are my patient rights?
What foods should I avoid?
Why is it important to know how safe some herbal remedies and supplements some are, and which ones help?
Why can’t I sleep, and is there something I can do?
How do I document treatments, including medications, and how they help or hinder me? What are common co-existing conditions and how can they affect FM, CFID & CMP?
What are the do’s and don’ts of exercise?
How big is big brother?
How can I help my doctor overcome fear of prescribing the medications I need?
How do I write my thoughts and feelings down, and why is it important to me?
How do I apply for the benefits I need, what are they looking for?
What is an appeals process?
How do I get my needs met at work?
Why is nurturing my spiritual side important to coping?
How can I resist isolation and feel empowered?
How do I accept what has happened to me and maintain forward momentum?

Continuing information will be posted on this blog. I hope you follow.

Celeste's Website

Celeste's Website
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