A Headache in the Pelvis, case history #6
Posted: Wed Sep 17, 2003 6:43 am
From Dr Wise, a patient's history, with permission ...
Patient Report after 4 years of doing protocol
In January of 1981, the morning after a stressful weekend of meetings and driving, I awoke to feel a sharp perineal pain and experience urinary urgency day and night. My groin, lower back and abdomen ached, my legs felt heavy and I could only obtain relief by sitting in a tub of hot water. These symptoms continued in various permutations and levels of intensity with only occasional periods of remission during 18 years of medical treatment until I learned about and made an appointment at the Stanford Urology Clinic in August of 1999.
As a result of perineal and pelvic-floor pain and constant urinary urgency, I had to limit travel by car as well as simply sitting for any extended length of time. Sleep was often interrupted hourly during the night by the urge to urinate. Pain would often be so uncomfortable that I only found relief by sitting in hot water for half and hour or more. I became depressed as each new round of antibiotics failed to make any beneficial impact, or only made a temporary improvement in my condition. I did not feel like socializing, and trying to sit and concentrate on my work became more difficult. I dreaded the possibility of living with these conditions the rest of my life.
My urologist treated me at first with long-term use of the antibiotic Septra. Sometimes after 4 to 6 weeks I would finally feel better, only to have the symptoms return a few weeks later, usually after some minor stressful event occurring in my life. After several years of unsuccessful treatment with antibiotics my urologist said my prostate had enlarged markedly and I agreed to have transurethal surgery. Pathology showed indications of inflammation but no signs of infection or malignancy. I recovered quickly and was glad to have the problem finally resolved. But 6 weeks after surgery all the symptoms once again occurred. I changed health plans and began a new round of treatment with antibiotics. Unsuccessful again, my doctors treated me over the next dozen years or so years with relaxants, tranquilizers, and nitroglycerin. I tried acupuncture, chiropractic, herbs, dietary changes and special exercises. I had a two-year remission except for minor episodes while practicing autogenic training, a form of deep relaxation.
Treatment at Stanford began with a written assessment of symptoms after which Dr. Anderson performed the most complete prostate exam I had ever experienced. He was able to eliminate the possibility of infection, and verify the existence of very sensitive pelvic-floor muscle trigger points. He reduced this build-up of muscle tension by massaging trigger points and stretching pelvic-floor muscles. He sent me home with the first four taped lessons of Dr. Wise's progressive relaxation course. I drove home sore from the examination, but with the first feeling of hope in many years. The next day I awoke pain free for the first time in a year, and remained so for the next year. I have returned for myofascial-release therapy twice when stress resulted in a brief return of symptoms. I met with Dr. Wise several time as I went through his 20 lesson taped relation course. Using deep relaxation with bio-feedback monitoring I became aware of tension throughout my body, especially in the pelvic floor. This awareness enabled me to use deep relaxation to release the tension build-up in the pelvic floor that mimicked the symptoms of true infectious prostititis.
I felt better -- no pain or urinary symptoms -- the day following my initial treatment at the Stanford Urology Clinic. I remained symptom free for about 1 year. Then myofascial release therapy provided another extended period of symptom-free living.
At this writing (September 15, 2003) it has been more than four years since my first treatment with Doctors Anderson and Wise. I have had two setbacks that lasted more than two weeks. In each case I saw Physical therapist Tim Sawyer and recoverd soon therafter. I have had three or four times where minor symptoms occurred for a few days but were relieved when I spent more time than usual on relaxation, stress reduction and physical stretching. So during the past four years I have been symptom free for all but about one to two months of that time.