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Episode 14: Why Your Postpartum Pelvic Health Matters with Dr. Robyn Wilhelm

April 15, 2020

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Jacqueline Kincer  00:42

Welcome to the podcast, Dr. Robin Wilhelm is here with us. She is a women’s health and pelvic physical therapist and a health and wellness mindset coach. And I’m so excited to chat with her today about pelvic health and anything else that we get into. So welcome, Robin.

 

Robyn Wilhelm  01:04

Hi, thank you for having me.

 

Jacqueline Kincer  01:05

Absolutely. It’s So amazing to have you.

 

And for anyone who’s listening, Dr. Wilhelm is actually local to me. And we’ve had the opportunity to meet in person and refer back and forth to one another. And I really wanted to bring her on the show, because she does pelvic physical therapy. And I wasn’t aware until I connected with her that this is a huge issue that a lot of moms face and that there’s so much to it that I just didn’t even realize myself as a provider helping new moms. And so one of the things I wanted to have Dr. Robin do before we get into it is chatting to us about your background and how you got into specifically pelvic PT.

 

Robyn Wilhelm  01:55

I have been a physical therapist for quite a while. I graduated in 2002. And like many therapists, there are different avenues that we can go into, so I did a lot of outpatient physical therapy work, which is a lot of orthopedics. So you’re working with a lot of individuals coming in post surgeries, individuals with different diagnoses that affect their musculoskeletal system. And I enjoyed a lot of that work.

 

I went to a skilled nursing facility. And then I actually also started teaching in physical therapy education because I always had that interest, even when I was in school. So I began to recognize early on now that I think about it. I’ve had some years under my belt, I feel like I started to recognize very early on in my outpatient experience that some women were coming into the practice who I felt that I could make headway with.

 

But I always sensed that there were some pieces missing, or something maybe I was not focusing on that could help even more. And as I’ve just grown in practice, and I’ve transitioned into different jobs, I also began to transition into wanting to learn and know more about women’s health, and very specifically pelvic health, because there is a division of physical therapy, where individuals’ interest in pelvic floor physical therapy can actually take additional coursework, there are certain certifications you can take if you take a certain series of courses through different kinds of associations. And so that’s where I really began to explore. And that was probably actually when I was in Ohio. So that was clear back in 2006.

 

So from that point on, I began to kind of build my toolbox and my knowledge so to speak, in regards to pelvic health, which is very specific to what it sounds like in the pelvic area. We look at things from a musculoskeletal standpoint, but obviously, as a physical therapist, you’re always considering the nervous system, your cardiovascular system, and everything that you possibly even as an IBCLC consider with your patient as a whole.

 

Jacqueline Kincer  04:14

Wow, yeah, that is just absolutely so fascinating. And I love just hearing about your different experiences. And I’m actually originally from Ohio, so that’s cool. I didn’t know that you were there. But we’re in Ohio.

 

Robyn Wilhelm  04:31

Yes. Northwest Ohio around Finley, Ohio.

 

Jacqueline Kincer  04:35

Okay, cool. I was born in Columbus. Well, that’s neat. So for any of our Ohioans listening, Yeah, that’s amazing.  Have you found a need for your personal self for pelvic physical therapy of any kinds?

 

Robyn Wilhelm  05:01

Yes, I think after, I would say that even though I started to have an interest in developing and learning more about women’s health and pelvic health, specifically this was prior to having children, however, especially after I had children, I felt like at that point, I really started to go, oh, okay, is this the things that I learned about. And, for me, I’m a cesarean mother.

 

Robyn Wilhelm  05:29

So from that avenue of personal experience, not being kind of told what to do for my body after birth, really walking away from the medical part of it the medical experience, and not feeling like I really had a good base of knowledge given to me about anything from my healing time to cesarean scar massage and how to watch that, to how my abdominals and my core may feel, keeping in mind that even though I had a cesarean and not a vaginal birth, I was still actually at risk for developing pelvic floor dysfunction in the future.

 

Pelvic floor dysfunction is just kind of an umbrella term. So things that fall underneath that is urinary incontinence, and pelvic organ prolapse. I just really didn’t experience any of that information. After I had my babies. Now, from my personal experience and my knowledge base. Thankfully, I was able to help myself. But unfortunately, I can’t say that any of that information and knowledge came from my providers, unfortunately.

 

Jacqueline Kincer  06:43

You know that is definitely a huge gap that I see. And, one of the things I love to do when I first start working with a new mom, especially if she did have a cesarean birth is, that so much of the focus tends to be on the baby, especially when it comes to breastfeeding.

 

And I just asked, how are you feeling in your body? And there’s just so many things, Oh, well, you know, I had a C section. So,  I basically have no core right now, and this and that. And when you’re fresh, and you’re initially recovering, we expect certain things, but, I just asked that question of them, Hey, did your doctor, your provider give you any information on just the trajectory of recovery here, and what you may need to assist in that?

 

And they kind of look at me, like, I have two heads when I ask that question. Because they’re like, What do you mean, I’m going back in like six weeks? So like, yeah, okay, maybe we should just have a little chat about those things. And I tried to give them a little list of things like you mentioned, some things that fall under that umbrella. And I never like to scare anyone, but for new moms, and maybe we want to break it down between c-sections and vaginal births. But for a mom who’s just had a baby, what are some of the things that she should look for in terms of what’s normal? What’s not normal? What are things she should keep an eye out for? To know that she needs to get more help when it comes to the pelvic floor area?

 

Robyn Wilhelm  08:06

Yeah, absolutely. There are some differences that can be expected if you have had a cesarean delivery versus vaginal delivery. And I’ll kind of separate those two a little bit, I would save for any mom postpartum some things that I’ll talk to, or even prior to birth, if I’m working on labor prep and delivery, and then just getting them ready. So when they go home, they feel like they have a little bit of knowledge.

 

As far as your pelvic health, a couple of things that are fairly normal after birth, don’t mean they should always be a long-term kind of common thing that you deal with. But we see this after birth.

 

Some people are still experiencing incontinence, they may have had incontinence towards the end of their pregnancy, and incontinence is urinary leakage. Or you can also experience fecal incontinence, which is actually leaking of the stool. Some people may experience that towards the end of their pregnancy. Some people may not and may experience it after the fact, because of the way our body has undergone either a major abdominal surgery for a cesarean or a major vaginal delivery where you get a really significant stretch of the pelvic floor muscles, you get some movement of structures, the bladder, the urethra that type of thing. People can experience incontinence because the pelvic floor, may be weakened and then also just structurally or, you feel a little bit different.

 

So it’s not uncommon to experience that after birth. However, if you’re going out into your fourth week, the fifth week, and sixth week and you’re still experiencing quite a bit of leakage, that’s a really good time to get in contact with a pelvic floor PT. Many pelvic floor PTs will do either virtual consultations or even phone or in-home consultations, maybe you just want to be able to ask a few questions, and then decide between you and the pelvic PT, you can decide, is it something that should be checked right away? Or should you wait a little bit, maybe until that six-week appointment with your doctor, and then see how things have changed because there’s a healing process there that goes on. So things can change.

 

So incontinence is one that sometimes happens. For many moms. beginning our return back to intimacy with our spouse or partner can bring on some apprehension, which is expected, it can also bring on painful intercourse. That is not uncommon, the first time that intercourse is tried post-delivery.

 

However, it’s very similar with the incontinence, if you are being sexually active with your spouse or partner, and you find that even into like, five weeks, six weeks, because some people start earlier, so I always say this, because the advisement is, maybe not to start that until six weeks, but I have had patients say, I just couldn’t wait and then I have other people that say, There’s no way.

 

Jacqueline Kincer  11:14

Yeah, wait for eight weeks. I hear that too. And I’m always shocked for those early adopters.

 

Robyn Wilhelm  11:21

I know. And, you know, and it’s funny, because I hear the gamut too. And I’m often thinking, as much as you tried to stay very professional, and don’t necessarily always throw your own personal experience. And I always chuckle along with them a little bit. If they say, I know, it probably sounds odd, but I just couldn’t wait. So I always say, I always include like, five, six weeks.

 

But anyway, so if you’re starting to be intimate, and it’s not necessarily the first time, but we’re talking about, okay, this is the third, the fourth or fifth time going even into and beyond your six weeks post birth. That’s also a good indication that a pelvic floor PT, maybe someone really good to contact. So just to find out if you have some hypertonicity in the pelvic floor, if you had a perineal tear? Is the tissue pretty tight right there, because you’ve had some scar tissue lay down? Yeah, there’s multiple reasons why intercourse can be painful. But that’s where pelvic PT’s jump in and are really the specialist in that to help you with that. So that’s also another topic. So we’ve covered incontinence and intercourse.

 

Another experience that people told me about, and I didn’t experience this as much personally, but it can be experienced by someone who’s had a cesarean or a vaginal delivery. I will say that individuals who have had a vaginal delivery are more at risk for feeling this. But people will talk to me about the heaviness that they feel through the actual vaginal area. Not necessarily uncommon after birth, many women sometimes will actually have a very, very minimal to grade one, prolapse after birth, which just means that the uterus, if it’s a uterine prolapse, which is the most common just means that the uterus is kind of down into that vaginal canal a little bit further down than what it usually is, or pre-birth.

 

So women can really feel that. Some women will explain it as feeling like a heaviness in the pelvis, they’ll explain it as if they sit on the toilet to use the restroom, it feels like there is kind of a ball or some kind of structure there. And they can just sense in their body that it feels different. This is not an uncommon thing. However, that should start to clear up and you shouldn’t feel the heaviness sensation if you can actually do a self-exam and you feel the tip of the cervix lower down in the vaginal canal.

 

Again, may be common, but by about six weeks of healing time, you should really start to notice that the heaviness goes away and you shouldn’t be able to feel that displacement of the cervix down as far.

 

Jacqueline Kincer  14:15

You know, I’m so glad you said that because after I birthed my second, I felt that heaviness that you’re describing and I did a self-exam. And now it was like a few days after I had birthed her. But I was like whoa, is my cervix supposed to be down there? And I contacted my midwife who’s a wonderful home birth midwife and knows that it gives a different level of care than I’ve experienced in the medical system and she was very reassuring and said, well, it can be really normal right now and I’ll check you when we do our next appointment. But you know, if it doesn’t go away, you want to see Dr. Robin.

 

And so sure enough, it did. But I think these are things that we don’t really talk about much and I’m glad we’re getting into the nitty gritty, because I think also there’s these jokes. I’ve seen little memes around about, like moms peeing their pants and their kids are like, 10.  And I don’t think we should be peeing our pants when we are 10 year old. So I think you agree and it’s awesome for you to share this.

 

Robyn Wilhelm  15:21

Yeah, and there’s certainly no shame in having older children past, maybe what we think is the expected time that we might leak a little here and there after birth, there’s certainly no shame in having even older kids and, you’re still experiencing leakage.

 

But definitely some of those memes. I try to roll with them as well, a little bit, right? But they’re kind of the pelvic PT’s worst nightmare, because it’s a really hard topic sometimes. Right? Because you want things to be able to be discussed and even maybe laughed about a little bit, right? I mean if that kind of opens up the discussion, then it’s not always a bad thing. What I often will say sometimes it’s like, I’m okay with laughing about it. But after we’re done laughing, can we talk about this further?

 

Jacqueline Kincer  16:18

Definitely not normal.  And, like you said, it should open up a conversation. And behind every joke is a little bit of truth, right? So we’ll. I don’t know about every joke, but that’s how the saying goes. And we should be able to have some humor about it. Hopefully not avoid  looking into care if it’s needed.

 

And one of the things I would love for you, and I get asked this by my clients, when I kind of give them, hey, here’s some things just keep an eye on as you’re going through your postpartum healing. And they love to ask you questions. Well, you know, what happens when I see a pelvic PT?

 

I think they’re very concerned about, they want to know ahead of time, what are the ways that they’re going to be examined and treated, and they’re concerned about being touched in certain areas.

 

And I’d love for you to just chat about what is it that you do when you work with people when you do a consultation, or when you’re treating some issues, and obviously not your technique or anything, but just so people know what it is that you do and what they would generally expect?

 

Robyn Wilhelm  17:32

Absolutely. I am set up in my practice, I think similar to you, meaning that currently, I’m owning my own practice. So I have some leeway, so to speak, and the amount of time that I spend with my patients also being a cash-based practice.

 

So when I see somebody for the very first time, usually their appointment, I let them know, to plan on an hour and a half. Because just like any medical appointment, you might go to, I have patients fill out an intake form, which just describes a lot of their medical history. I’m sure all the listeners out there probably have done one before.

 

But I actually sit with them for a good 20 to 30 minutes, and we go over that form. Of course, some of the sections are just checks and boxes. And so I know some of their history. However, going through that obstetric gynecologic history, going through the history of their birth, even their birth experience and how they birthed whether it was a c-section, vaginal, did they have a perineal tear? Do they have any episiotomy? Do they recall what position they were in when they birthed their baby? The reason I asked such specific questions, and of course, always encourage them to share what they can and what they’re willing to share. But I asked such specific questions, because if they’re seeing me for pelvic floor, core issues, oftentimes, those questions can be very pertinent to what I see and what I experienced when I do an intra vaginal exam.

 

So we go through that section. I always tell all of my patients upfront what to expect with the exam. So typically, I use my pelvic model at that time. I have a pelvis model there. It shows all the pelvic floor muscles. And I basically take them to step by step into what I’m going to do just so they know ahead of time because you’re absolutely correct. Sometimes the apprehension, the apprehension of touch can be huge for many people. So we always consider that right?

 

Even if it’s not an internal examination, you never know, for sure, even if you ask because some people may not tell you.

 

You’re not quite sure if they’re coming with a history of any kind of trauma or anything like that in their background. So I will let them know that they’re in 100% control of the exam. If any time, if they want to take a pause on the exam, and I tried to make it light-hearted, I’ll tell them, if you feel touched out, if you’re just like, yep, that’s enough for me today, you’re 100% able to do that, because they’re really in control of it.

 

So after I have that discussion with them, and let them know what the pelvic exam includes, then of course, I do that. The pelvic exam itself, when you go to a pelvic floor physical therapist, we use one digit or one finger to do an intra vaginal exam. Of course, we’re always gloved, we use a lubricant. So as far as you know, anyone that’s worried about, I’ve experienced a lot of vaginal dryness, I’m not sure, I’m already experiencing some pain down there. So I’m a little worried about being touched. Also, we take measures to try to help with that. Being that we’re doing the exam, by person and not some machine or something like that, we can take our time.

 

So there’s three layers to the pelvic floor. And with my patients, I tell them, I’m going to go and be touching on each one of these layers. But I’m going to tell you before I go into the next one, of course, there are some patients that the exam takes longer, because maybe I am very slow with it just based on their response, maybe based on some of the symptoms they have. But a pelvic floor exam in general, doesn’t really take too long.

 

What I always tell people too beforehand, as I say, this is gonna be somewhat similar to when you see your midwife, or your gynecologist, but the difference is for pelvic PT, we’re not placing like a speculum in and then opening up the space. Right?

 

I mean, our gynecologist, our midwives do that. And that makes sense, because they’re wanting to do a Pap test. And, check us for things, pelvic floor PTS, or pelvic PTS, we actually are wanting to feel those muscles. So we’re actually going in and we might be doing some stretching and asking you how that feels? So that’s a big difference, too. I honestly can say in my practice, that even with patients who come in with maybe no good degree of chronic pelvic pain, I can say that most, well, all of them have said to me afterwards in some way, or form or fashion, because I always check in with them and ask if everything’s okay. And if they’re doing good. All of them have said, Okay, that wasn’t as bad as I thought it might be.

 

Jacqueline Kincer  22:31

Oh, that’s amazing. And what I hear and I say is, yeah, that you just take this really just compassionate approach. You’re not just this PT going in there. It’s a very cooperative process. You’re getting feedback from your patients. And honestly, it just sounds really beautiful.

 

Robyn Wilhelm  22:54

Yes, it’s very! Although as pelvic PTS, we all can have our own sense of oddity and humor and things about stuff. But when it comes, like many healthcare professionals, I suppose, right?

 

But when it comes down to the actual exam, yes, I would definitely describe it as something that is done with a lot of compassion, a lot of consideration. I really, truly believe in hope that all physical therapists are approaching that no matter what setting but obviously, in a pelvic physical therapist setting, we’re working in a very intimate area of people’s bodies, right? And so we really need to be able to detect and get an idea from them. What are they thinking about? Before they even came, or what questions maybe they have of me before I just get in there and say, Okay, let’s get this pelvic exam done.

 

Jacqueline Kincer  23:45

Yes, yes. That’s excellent. And I know that we had a mutual patient. And, I kind of preface the moms I work with as well when I’m doing a breast exam, I guide them through it. And I’m going to touch here and here’s how I’m going to feel and Is that okay with you? And let me know if anything’s uncomfortable, or you’d like me to stop and very similar, and the one who had seen you before me said, Oh, I’ve already seen Robin, this is no big deal. And I thought, well, I guess a boob isn’t quite the same as going into vaginally. But it was just really funny. And we had such a great laugh in that moment. And so I felt like you would actually really prepare her for working with me.

 

Robyn Wilhelm  24:29

Great!

 

Jacqueline Kincer  24:30

Yeah, it was awesome. And all of this talking got me really curious to thinking about are there things that could be an issue for women even before they get pregnant, that they may have some pelvic floor dysfunction that does not lead to any issues during pregnancy or birth if those things are existing ahead of time?

 

Robyn Wilhelm  24:59

Yeah, yeah. For sure, it’s really interesting as a pelvic PT, I get to experience patients who come in I do work a lot with individuals who are pregnant or postpartum.

 

However,  I’ve worked with young women who have not been pregnant. And just to touch on a few things that can even happen and kind of that nonpregnancy type of population, so to speak. Vaginal dismiss is a diagnosis which not important to always know the full name of but that vaginal dismiss is a pain that’s experienced in through vulva tissue, possibly more so vaginal tissue.

 

And it does not just pain with intercourse, but also pain with things like if they’re trying to insert tampons,  any kind of physical touch to the area, or internally within the vaginal canal that causes pain is something that some women experience prior to pregnancy.

 

And I’ve had quite a few women come into my practice with this diagnosis. And one of their main concerns, when we’re talking for the intake is, I often hear I’m really nervous about becoming pregnant. Because obviously, it makes sense, right?

 

If you think about pregnancies, obviously leading to birth, you have a great chance that it’s going to be a vaginal birth. So for somebody that experiences chronic pelvic pain, vulvar pain, which is just the outside tissue really of the area that we always kind of refer to as the vagina which is truly the vulva area. And then if you have pain in the vagina itself, even with intercourse, or tampon insertion, the thought of having a child can really be scary for people.

 

So anybody who has experience with any type of pelvic pain, because even though, it sounds very basic, right? Pelvic pain, well, my goodness, why is it being caused? But that’s my point, that’s a very good reason to get yourself to a pelvic floor physical therapist to try to find out what is driving the pain, what is causing the pain, and how can you address it.

 

And then vaginismus, which is a little bit more specific. So people have probably been to a gynecologist and already been diagnosed with that. But it’s along the same lines, definitely getting into a pelvic PT, just to make sure that you can prep yourself as best as possible if you’re a woman that’s looking forward to and wanting to get pregnant. And quite honestly, for a lot of the people that I’ve seen, kind of calming some of their fears about getting pregnant and about experiencing labor and delivery, because there’s so much that can be done, not just the initial kind of direct treatment for the condition. But then also helping women prep for labor and delivery, really specific to the pelvic floor can be so educational and empowering for people. And you and I both know when people feel like they’re more knowledgeable about their body or about something that takes the fear level down a little bit. If not, you know, all the way.

 

Jacqueline Kincer  28:08

Yes! That is so true. And that’s why I really wanted to bring you on the show was so that people could learn more about pelvic floor dysfunction. And know that is something that is treatable. You don’t have to go the rest of your life with painful intercourse, or incontinence, or any of these other things we’ve mentioned, that there’s someone out there that can help you but to also just let people know what it’s like to work with someone like you to remove some of that fear, right?

 

I don’t feel like I know many women just in my circle of friends that aren’t clients of mine, that have these conversations. I feel like it’s a very right sort of taboo, you’re not going to say to your neighbor, hey, by the way, my vaginas kind of hurting. Do you got anybody I can see?

 

It’s just not really a great solution most women have, unfortunately, and I think there can be a lot of shame around these topics that people place on themselves internally, and they may feel like, oh, gosh, something is wrong with me or my body and we really don’t want people to feel shame, we want you to definitely at least move to a state of acceptance but also just more knowledge about things you can do to improve how your body feels. And I know you feel the same way.

 

Robyn Wilhelm  29:34

Yes, I think we are seeing you and I as helping women. I think we are seeing the changes occurring with the stigma with fee increase conversation. I think we’re beginning to see it.

 

I feel like the last five years, especially five six or so. I feel like the conversations are being had more. I know within my profession I’m seeing more and more new grads.

 

I was a professor for quite a long time. And I have even students contacting me, my old students and their new grad,  they’re not even new grads now. And so they’re out and working. And they’re contacting me and saying exactly what classes did you take? And how did you get into women’s health?

 

I’m seeing more pelvic PT sprouting up, which I think is awesome because most people don’t realize this, because like you said,  it’s still a little under wraps, right? It’s still a little taboo. But there are so many people that are truly, and I don’t always want to use the word suffering, but are truly experiencing or having to deal with the hardship of pelvic floor dysfunction, which dysfunction is a hard word, it doesn’t mean that you’re broken, it doesn’t mean that things will never work.

 

Dysfunction just purely means that the function of your pelvic floor is not as optimal as it could be. So you’re experiencing, a gamut of a couple different things, right?

 

Maybe it’s incontinence, maybe it’s pelvic pain that you just can’t figure out why it’s there. Maybe you’ve been diagnosed with endometriosis, Maybe you have pelvic organ prolapse, but nobody ever really told you about it.

 

All those can kind of fall underneath that big umbrella of pelvic floor dysfunction. And we’re seeing a lot of younger women coming out and starting to speak more about it. And there’s been numerous studies done. And I remember in one study, specifically 37% of the female athlete. populations they looked at so we’re talking to lead IQ athletes. So we know approximately, like in their 20s, so to speak. 37% of them had urinary incontinence issues.  So it’s not just an issue.

 

Jacqueline Kincer  32:02

That’s just not an issue for people who are pregnant?

 

Robyn Wilhelm  32:04

Well, you know, it used to be that we thought it was really just an issue for geriatrics or people that were older, right. But we’re learning differently.

 

Jacqueline Kincer  32:14

Wow, that is so fascinating. And yeah, you don’t know what you don’t know.

 

And like you said, people that have these things that they’ve never been diagnosed or assessed. And I know there’s been things like that in my life, I just nerd out on all types of various health care out there. Because, I mean, I was even telling you before this podcast, I had some injuries from motor vehicle accident. And I’ve been to several physicians in this journey. But I went to one today, who actually was able to tell me which of my vertebrae was rotated in which directions. And that’s like new information that I was able to have that could actually totally change the directory of treatment versus, you know, being stuck on medications for the rest of my life, or potentially facing some very serious surgeries down the road.

 

So if we can be more thorough and less invasive with people, I am all for it. And I’m sure there are things that I mean, I’ve seen the what the incontinence drugs advertised on TV and the side effects of that. And , there may be a time and a place for those things, but maybe also those things are being over prescribed and could be helped by someone like you.

 

Robyn Wilhelm  33:31

Yes, I think a holistic approach to things is, is definitely the way to go. And that’s been talked about more in the last several several years. But you bring up a good point, even with your own personal story, what can you do for yourself at this point, that can maybe not 100% safeguard you for things in the future.

 

But imagine us as women, dealing or addressing or being able to talk openly about any kind of pelvic health issues or sexual health, core, pelvic floor, anything we’re having now,  even young teenagers experiences or, or a young woman or somebody who is currently a mom.

 

As we grow older for women, we just continue to go through fluctuations of hormone cycles during pregnancy after pregnancy. And then into perimenopause and menopause. So really, anytime that you can get help, and you can feel like you can open up and talk about these issues. That may well very much help you to avoid some things going into our later years of perimenopause and menopause too.

 

Jacqueline Kincer  34:42

Yes, yes. And on that note, too, what I want to encourage our listeners is there are lots of us out there, it could be your IBCLC, it could be your OB it could be your care partner, it could be your acupuncturist, it could be anybody right?

 

And if you can just sometimes just sharing with them things that you don’t think that they can actually treat directly, but seeing if they know someone who can. I know a lot of times people will say, I know you just help with breastfeeding. But you know, I’ve got this issue, my son’s tonsils are swollen and we don’t know what to do they just want to take him out, is there anything else? And I’m like, Hey, I actually know a lot about that. And I know this person that you could go see. And so sometimes,, I try to know, just a wide breadth of professionals out there, because I inevitably do have those patients and clients who think Oh, my questions unrelated, but you’d be surprised sometimes you bring up something to someone.

 

So, if you if you don’t know of a pelvic PT directly, or having trouble finding one, start asking around to, either other friends you may know, or maybe even a healthcare provider, especially a holistic one, because they’re definitely out there and wanting to serve. And I actually, that brings me to something I’d love to ask you.

 

So we’re recording this episode on March 23 2020. And so unless you’re living under a rock, we’re in the midst of a pandemic here. And so, skilled providers like Robin and I are currently closed for physical business, but we are doing telehealth. And I bet a lot of people would say, Well, how is a pelvic PT going to do a video consultation with me or a virtual consultation? But you are offering those and you kind of hinted at that a little bit in the interview. So I’d love to not only just discuss what you’re able to offer during this time for anyone who is listening to this episode recently, or should this continue for much longer? And also how people can reach you?

 

Robyn Wilhelm  36:45

Yeah, absolutely. Thank you. So, yes, that’s a very good question. I do have even my current patients who I had contacted to let them know that the doors unfortunately, were closing, I felt good about that decision, ethically, but it’s still hard, right?

 

You always want to be there for your patients in person if you can, but telehealth and virtual online physical therapy assistance, and help is not new at all.

 

So there’s some PTS out there that have been doing that for quite a while, depending on what state you live in, and all the rules and regulations. But when I talked initially a bit ago about what is done on that very first visit, there is the whole intake process, getting to know the patient, knowing their history, all of that is wonderful to do be able to do online via video chat. And that takes about 30 minutes, 20 to 30 minutes.

 

In going over symptoms with people, I’ll use a most recent example, I had a new patient last week, and it was a virtual consultation, we were able to discuss all of her symptoms, she was able to describe to me what she was seeing and feeling. And based on my knowledge and my experience with patients, but then the working knowledge, right?

 

The classes and courses and textbooks and everything, I was able to set her up on a home program that she’s going to begin to initiate and then I also educated her about,  this is how you would know when to stop this or you know more of your adverse reactions..

 

So, because I’m not getting to do the actual intro vaginal exam, but listening to the patient is huge. So based on what she’s telling me, and based on her symptoms and signs, I can get her started on a few things at home, to address her symptoms. And then she and I together can really stay in close management about that. So she knows, like, if I do this, and it kind of feels worse, okay, this is what I need to do next visually, it’s very nice, because I was able to just step back from my screen, and I was able to demonstrate exercises to her, she was able to step back and demonstrate them back.

 

So although it is different for us, because we’re usually used to being in clinic, it is actually working out pretty well. So definitely, if you are listening, and we’re still in the midst of this, definitely reach out for those telehealth visits. I know they can seem a little, apprehensive about them. But she was very happy that we were still able to chat because all of the information I gave her just in and of itself, I think really took away some of her just fear about the situation and not knowing even what to do or how to start. So it was really, really helpful. And I’m still using my same clinic website that people can book off of and then just within the booking options, people see that virtual consultation.

 

They’re awesome. That’s so wonderful. And I love what you shared is, what I don’t want people to do is delayed treatment of any kind or delay assessment. And so having you as an option to do this and the same goes for what I offer in terms of breastfeeding and lactation support, we’re still here to help you during these times. And there’s definitely times where I do that for people who live really remotely.

 

I’ve done telehealth for years, like you said, this isn’t new. There are people that are like, well, do I drive three hours to go see this person? Or can I do something online first, and if I need in person I can, right?

 

Jacqueline Kincer  40:28

And so there’s a lot we can do. And during this time where people are feeling stuck in their homes, unsure, maybe fearful, to add on top of that any kind of physical discomfort that your body’s in, that’s definitely not going to help you navigate this time and may create even more anxiety. So we want to do what we can to diminish that for you. And I love that you’re doing your part to serve these women.

 

So what is your website? Where are you on social media? We’ll link all that up in the show notes. But I know some people love to just hear it as well.

 

Robyn Wilhelm  41:02

Yeah. So my website is actually my last name, which I’ll spell just briefly because it can get a little humble jumbled. So it’s www. wilhelm.com.

 

And then actually I share as much as I can. I enjoy sharing and educating on social media platforms. So on Facebook, you can search under Dr. Robyn Wilhelm. And I’ll probably pop up and then for Instagram, my handle I believe they call it. Yes. If I’m keeping up on things here is Dr. Robyn pelvic PT might you know I should say to that, that Robyn is with a y. So that does make a difference. Dr. Robyn, pelvic PT.

 

Jacqueline Kincer  41:51

Awesome. Awesome. And like I said, we will link that up spelling all correct links, working, and all of that. So you can head over to the show notes, either on your favorite podcast platform or go to oh my gosh, what’s the URL for my podcast? Breastfeeding talk podcast.com, I believe is what it is. So there we go.

 

Well, thank you so much, Robyn, for being here today. I feel like you shared a ton of awesome information with us today. But I really feel like it’s gonna help empower our listeners and you all who are listening. There’s a lot for you to take in here. So no worries if you listen to these important ones. But thank you, Dr. Robyn, for taking the time to share your expertise. And everything you know with us. It’s truly a pleasure.

 

Robyn Wilhelm  42:46

Thank you. Thank you so much for this outreach, I think I know as a pelvic PT, I appreciate it. But I know you’re having wonderful speakers on I haven’t even got a chance to listen to all of them. But I know that it’s a plethora of information. So thank you.

 

Jacqueline Kincer  43:01

Oh, you’re welcome. Alright, see you next time.

In this eye-opening episode, we are talking all things postpartum pelvic health with Dr. Robyn Wihelm! She is a Women’s Health and Pelvic Physical Therapist and Health & Wellness Mindset Coach currently offering virtual consultations and in-person visits in Mesa, AZ. If you’re like most new moms, you may be wondering why pelvic physical therapy is even a thing and why you’d need it. In this episode we are discussing the importance of pelvic pre-pregnancy, during pregnancy, and postpartum. In fact, many countries outside the US have it as part of their healthcare model.

If you enjoyed this episode and it inspired you in some way, I’d love to hear about it and know your biggest takeaway. Take a screenshot of you listening on your device, post it to your Instagram Stories and tag me @holisticlactation

I’ve got a special gift for all my listeners and it’s 38 powerful breastfeeding affirmations to support you on your breastfeeding journey, so go get that free audio now at https://jacquelinekincer.com/mantras

In this episode, you’ll hear:

  • What is pelvic physical therapy!?
  • Signs you need to be evaluated
  • What pelvic PT is like
  • How your pelvic health is important for your postpartum and breastfeeding journey

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