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Carrie Pagliano PT
United States
เข้าร่วมเมื่อ 5 เม.ย. 2020
What did you think the first time you looked? Freaked Out or Curious? 🤔 Let's Talk Down There
Freaked Out or Curious? 🤔 Let's Talk Pelvic Floor Awareness
Navigating pelvic floor injuries can be overwhelming, involving both our bodies and minds.
Are you hesitant to take a look?
Maybe it feels uncomfortable, or maybe you’re worried it’ll make symptoms worse.
Or, could it actually help you understand what's going on with your body?
Did you make the choice to explore, or was it something you felt pressured into? How did that shape your experience?
Let’s dive deep into the importance of awareness and discuss what it’s like to check in on your pelvic health for the first time.
Your experience matters - drop a comment below! 👇
#PelvicHealth #PelvicFloor #PostpartumJourney #WomensHealth #PelvicFloorInjury #SelfAwareness #PelvicOrganProlapse #PelvicPain #PelvicPT #SelfCare
#paglianopostpartum #pelvicfloor #vagina #vulva
carriepagliano.com
Dr. Carrie Pagliano has been a dynamic leader in clinical care and education in the areas of women’s/pelvic health and orthopedics for nearly 20 years. Dr. Pagliano received her Masters in Physical Therapy from the University of the Sciences in Philadelphia in 1999 and Doctor of Physical Therapy from the University of St. Augustine for Health Sciences in 2007. Dr. Pagliano is a double Board Certified Clinical Specialist in Orthopaedics and Women’s Health and holds Manual Therapy Certification from the University of St. Augustine for Health Sciences. Dr. Pagliano is the founder of Carrie Pagliano PT, LLC. For over 10 years she was the program lead/founder for the Pelvic Physical Therapy clinical program/physical therapy residency at MedStar Georgetown University Hospital in Washington, DC.
Navigating pelvic floor injuries can be overwhelming, involving both our bodies and minds.
Are you hesitant to take a look?
Maybe it feels uncomfortable, or maybe you’re worried it’ll make symptoms worse.
Or, could it actually help you understand what's going on with your body?
Did you make the choice to explore, or was it something you felt pressured into? How did that shape your experience?
Let’s dive deep into the importance of awareness and discuss what it’s like to check in on your pelvic health for the first time.
Your experience matters - drop a comment below! 👇
#PelvicHealth #PelvicFloor #PostpartumJourney #WomensHealth #PelvicFloorInjury #SelfAwareness #PelvicOrganProlapse #PelvicPain #PelvicPT #SelfCare
#paglianopostpartum #pelvicfloor #vagina #vulva
carriepagliano.com
Dr. Carrie Pagliano has been a dynamic leader in clinical care and education in the areas of women’s/pelvic health and orthopedics for nearly 20 years. Dr. Pagliano received her Masters in Physical Therapy from the University of the Sciences in Philadelphia in 1999 and Doctor of Physical Therapy from the University of St. Augustine for Health Sciences in 2007. Dr. Pagliano is a double Board Certified Clinical Specialist in Orthopaedics and Women’s Health and holds Manual Therapy Certification from the University of St. Augustine for Health Sciences. Dr. Pagliano is the founder of Carrie Pagliano PT, LLC. For over 10 years she was the program lead/founder for the Pelvic Physical Therapy clinical program/physical therapy residency at MedStar Georgetown University Hospital in Washington, DC.
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I'm 64 had 6 children got 1 2 yrs ago every 4 mths go and get it checkd 6 weeks ago I thought I would try with out I lasted a week nt good so I just got it back in best thing I did it's fantastic size 3 little horn 😅😅 I totally recommend
Thanks for sharing!!
Actually, virtual PT is completely useless. You DO NOT get the same experience as an in person visit. No one will ever convince me. Same with a doctor visit. You need to exam the person, in person. You just want to work from home
I would agree, for many providers it's not the same. I'd argue my virtual sessions are actually better than many in-person sessions for some providers which is why women see me for a 3rd or 4th opinion & they get results!
❤
This was soooo good. Was just prescribed while breastfeeding! I’m just curious when you can stop. Once breastfeeding stops? I typically nurse for 2 years…
But I’ve nursed my other kids while pregnant so my estrogen definitely wasn’t down then!!!!! This (#4) is my last baby and definitely feeling the urinary symptoms while nursing.
Depends on your symptoms. We're going to have a researcher on to talk about this in a few weeks, Sara Perelmuter
Come tell my wife to get her lazy ass up. 😅😅😅😅😅😅
Hi, is it true that once you’ve reached stage 2 prolapse, no exercises will help?
Nope. Not true at all. Prolapse stage doesn't always equate to symptoms. The goal isn't necessarily to change the anatomical stage, but to change the symptoms. Is this something you're navigating?
@@carriepaglianopt thanks for your kind response. I am just about to start trying a series of exercises I found on TH-cam because at the very least I don’t want my stage 2 (bladder) and stage 1 (uterus) to become any worse. I was checked and so far no urine is being trapped, and I no longer have incontinence issues after a few therapy sessions that specifically addressed that
Regarding symptoms, wanted to add that I hadn’t had any leakage when coughing, sneezing, etc…. Only when running to the bathroom due to stress .. Doctor thinks some of that was also psychological, partly because I’d had many UTIs in the past.
I have a chronically tight left obturator internus muscle which really messes with my pelvic muscles. I’m shocked at how much difficult it is for me to do this exercise despite being in shape. I’m gonna keep developing this ! Maybe this gets at the crux of the problem for me
Give it a try
I have had a pessary put in two weeks ago...the ring type, i suddenly had a sharp pain coming up to my navel and it was not gojng away, also i found when i went to urinate i had a burning in my bladder and that was stopping me from wanting to go to the bathroom just because i did not want the burning, so i promptly took it out, im a heart patient and i didnt want inflammation, i used some herbal stuff included aloes, probiotics and its stopped burning. I have a clinic appointment soon but i don't think I want the risk of a pessasry sgsin, im 78years
If you're in pain definitely follow up with your referring provider. Super important that the fit is good, the tissue is healthy & tolerates the pessary. Should never hurt & you shouldn't feel it when it's in
Thank you for starting this conversation, Carrie.
Thank you for listening
I didn't hear of a pessary until a few months ago when my sister got one as she waited for the procedure to get a hysterectomy. Im 69. In last four years I have not seen a doctor on a regular basis. I looked on the internet as to why I had fullness feeling in the uteres area. I was surprised to find prolapse is common for women that went through child birth. I don't remember a doctor ever mentioning anything about this condition as being something to watch for. I bought myself a belt that holds the pelvic floor and that helped a lot for more than a year. After hearing about the pessary I made a doctor appointment and got one before a 3 week long road trip that I came back from just days ago. Wow! I'm so thankful for this device. It has been a big relief regarding the ease of it and not having to fumble with velcro closure tabs that were losing their grip. I didn't bother with it during the trip other than to use a cream a few days each week. ( I cleaned it after I got home) I plan to use indefinitely but not sure of negative side effect the pharmaceutical cream may have after a long period of time. I prefer not to have a hysterectomy.
Great to hear! SO many more conversations about pelvic health concerns including prolapse. There's a lot more that we can do now as we're understanding why these things happen & we don't have to just accept it! Glad you found what works for you!
I have had a pessary for about 10 years…ring type…first one was larger but was causing abrasions so my gym switched me to a smaller one. No more leaking when I walk, dance, play tennis, cough. It is a godsend and I highly recommend his device. My attempts at kegels don’t work and I sometimes have mild infections after removing or inserting. Don’t have a prolapse. I have difficulty getting it out myself but I use a dental floss string to help me get it out. I am 78 …are you suggesting that I can get along without it at some point?
We don't have a lot of information around tapering off pessaries. As we start to use them on patients who are earlier in their postpartum journey, that's when there's more opportunities for the anatomy to change in that first year & need support- more likelihood there to taper off. At 78, (of course depending on WHY you're having symptoms) I wouldn't mess with what's working! Glad it's helping you!
I have my third pessarium now. First was out in 40 meters walk and 2 stair steps. The second managed to stay in for 50 meters and a full stair. The second I have taken home. After a few days I tried to insert the pessarium myself at home. It stayed in for several hours. Walking and cycling no problem. Peeing was fine, but with pooping the pessarium came out. Shit. But the support was just fine. The first two were with disks with supporten membrane and holes. Then the gynaecologist fitted me a third, a simple ring. It felt unpleasant, with pressure all over the pelvic area. We agreed to give it a bit more time. After a few hours I took it out. Immediately the headache was gone. Actually, today I have inserted it again. Unpleasant. I try to keep it in for the 8 hours. Luckily I still have the second pessarium.
Getting a good pessary fitting can be challenging. Sounds like you have a provider who's willing to work with you
Quick & easy❤
Love doing these at home
Awesome 👍
Im 24 years postpartum. Still trying to get back in shape.
These are actually awesome for Peri/meno women trying to keep the agility up (decrease fall risk as we age!) never too late 🙏
Hello, I have analyzed your TH-cam channel and found some problems in your channel. Can we discuss the problem that your channel has?
Thanks but no thanks! Have a great day!
Thank you for making this video! I am going to give this a shot, in combo with my PT this should hopefully move things in the right direction
Sounds great! Keep me posted!
Hello, I have analyzed your TH-cam channel and found some problems in your channel. Can we discuss the problem that your channel has?
Thanks but no thanks! Have a great day!
So essentially low estrogen = weak pelvic floor and high estrogen = tight pelvic floor?
No. They're different aspects of what can impact PF symptoms. "Tight" or high tone is a matter of functionality & capacity. (Think muscle activity) Estrogen impacts the tissue quality & blood vessels. Low estrogen can mean less support & integrity. You need to consider all the parts in a diagnosis. Hope that clarifies.
Brilliant!
Thank you! Let me know what you want to learn more about!
Very neat
Thank you! Cheers!
1st coment
Thank you! Let me know what you want to learn more about!
Had to laugh at the first comment as to why 😂😂😂
ok
Help me with the meaning of cue. Is an example “ engage your core and pelvic muscles as you breathe out”? We at long last have a pelvic floor physical therapist who’s back in the office, and so this encourages me to go get the individualized care instead of TH-cam only.
Cystocele over here (did I spell that correctly?)
a cue is a word or tactile input that a provider would use to elicit a certain result. If I tell you to "exhale before & during effort" that's considered a cue. If I were your provider & placed my hand (with consent) on your abdomen & asked you to draw your belly button away from my hand, that would be a cue.
Have been in tat for years and basically overcome. Naturals, herbs certain one work, the body changes need to listen. Yes I do believe it is hormone involved. Kagel till the cows come home, pharmaceutical for me did not work and the side effects horrendous. When you are pregnant the body produces a relaxen hormone. I think this maybe a major player in the issue.
The "relaxin" issue is not really a thing. It's estrogen. There was a systematic review looking at the role of relaxin in pelvic girdle pain in 2012 & this was basically debunked. Estrogen fluctuations impact the tissues the most. Unfortunately providers have attached themselves to this concept and it persists without evidentiary support. www.ncbi.nlm.nih.gov/pmc/articles/PMC3459115/
I'm 64, had stage 2 prolapse in August, 2023 and Kagel made the leakage worse so I stopped doing it right away. It had gotten worse to stage 3 in early 2024 so I decided to try the ring pessary. It was a god sent and gave me all the support I needed. I didn't feel a thing and was able to get back to normal right away for the most part. I first tried a smaller size and it fell out in two days. I tried to put it back in myself but wasn't able to push it in deep enough while keeping it folded. Then I was re-fitted with a larger size and this one has been staying in pretty well. I requested to schedule a cleaning/refitting every three month as I couldn't do it myself. The pain, discomfort, and leakage before using the pessary stopped me from doing anything that requires standing for as short as 3~5 minutes and it was horrible. I thought about going for surgery as soon as possible and the pessary saved me. I still want to fully enjoy my go-go retirement years.
Glad you found something that worked for you!
Might trigger some people but pelvic floor physical therapy is highly overrated.
I’m being told that I need it but I don’t see it helping, I honestly think my issues are lack of core strength after 4 major abdominal operations…
I kinda feel the whole disease is heavily under researched. Like the therapists are only focusing on improving the tone of those muscles, whereas, in my experience, the problem is often musculoskeletal meaning relating to both muscles and our skeletal structure. In lot of the cases, I’ve gone through over the internet, people who’ve experienced pelvic floor issues had underlying postural problems such as posterior pelvic tilt, poor femur IR, etc. Not sure about your case specifics, but see if you too have had such skeletal issues. If so, work on those areas simultaneously w your PFT and I’m sure you’ll see an improvement.
Bones are just bones without muscles. Posture also isn't everything. When we see people with a variety of postures and movement patterns that aren't symptomatic or in pain, it opens your eyes that were resilient, adaptable & have different strategies. MSK is musculoskeletal but again, bones are nothing without muscles to move them. Sounds like you have a bias...might be worth examining if you're curious.
Operations can definitely result in weakness & restrictions due to scarring. I've had 2 c sections and I agree, definitely challenges!
Let's discuss if one is constipated, like my Grandma was due to some sort of prolapse and they just dump miralax in& give other laxative s. THAT, I THINK EFFECTS NUTRIENT ABSORPTION AND HASTENS BONE LOSS.
Lots bigger issues to address nutrients and bone loss. An even bigger issue if your grandma gets impacted and can't get her stool out. That's an emergency situation. Prolapse can make that difficult because of pocketing in the rectum. Having lots of issues as we get older is an even bigger reason to weigh out all the options & get the best overall solution for that person
Such an insightful episode highlighting the complexities of perinatal mental health, as well as, providing new information on staying active postpartum and dealing with intrusive thoughts throughout pregnancy. Highly recommend a listen!
Thank you! We had a super fun & informative conversation!
😳 'Promo SM'
MY 88 YR OLD MOM HAS HAD A PESSARY IN FOR 6 YEARS WITHOUT HAVING IT TAKEN OUT. SHE HAS BEEN BLEEDING FOR OVER 2 YRS STRAIGHT. I HAVE FOUND HER 6 SPECIALISTS, AND NOT UNTIL I GOT HER INTO A SMART FEMALE OB/GYN DID ANYBODY MENTION THEY SAW THIS PESSARY WAY UP INSIDE HER. SHE WAS TOLD SHE CAN'T HAVE SURGERY ON IT OR IT WOULD CAUSE A COMPLETE PROLAPSE. SHE HAS BEEN AND OUT OF HOSPITALS AND MEDICAL CARE FOR THE LAST 2 YRS. SHE GAS HAD MANY TESTS, XRAYS, SCANS, AND EVEN SURGERIES WITHOUT ANY DOCTOR SEEING THIS PESSARY. WHAT WOULD YOU SUGGEST DR.CARRIE?
😢
I think your mom is lucky to have you advocating for her & needs providers who will help her make the safest choices for the best quality of life!
Omg that is just insane. Someone needs to get it out of her
Just came across your video. Never thought about p f from that angle. Am in pt for grade 2 cystocele and rectocele which is helping. Someone mentioned d3 and k2 which will be part of my diet. Thanks
Lots of options to navigate prolapse because there's so many different presentations
Just discovered Dr Stacy Sims a few weeks ago & I’m shocked at how many things estrogen plays a role in. She speaks a lot on female athletes, which I’m not, but listening to all her menopausal knowledge I’m hearing things I hadn’t come across the past couple of years. She gets into the nitty gritty science, & learning the whys & hows to me helps it make sense. I’m trying to crawl out of a post menopause HELL that should’ve been obvious to the myriad of doctors I’ve seen but I’m having to educate & try to advocate for myself.
Unfortunately since the WHI study misinformation surrounding menopause and fear mongering HRT has been rampant. We're just starting to get a handle on things again & get better info out! I'm sorry you have been suffering!
I’ve gone down that rabbit hole and it made me very discouraged
It's definitely tricky!
Thank you so much for having me! - Dr. Waggel
Our pleasure!
Such an eye-opening conversation with Dr. Waggel and Dr. Pagliano! They delve into the world of perinatal mental health, sharing their insights and personal experiences with authenticity. A must-listen for anyone navigating the complexities of perinatal mental health!
Thank you ♥️
Honestly, evaluating progress can be a bit tricky. Right now, I go monthly, because of financial reasons. So, that has an impact. Also, even before I ever started, my symptoms varied. I'd go for months in a row with more severe symptoms and several months with not too many problems. And the PT may notice improvement while evaluating me but maybe it hasn't translated into symptom relief, yet. Yesterday, I had an appt and I had improvement in one area and regression in another area that I only knew about because she did an internal evaluation. Overall, I do know that I've made progress since I have started. But, it took a while to know for sure because my symptoms varied.
Having lots of symptoms makes it tricky for sure
@@carriepaglianopt I think my use of the word "varied" made it unclear. They varied in frequency and regularity, not type. Even before treatment I would have stretched of bad months and stretched of better minths.But I guess either would muddy the waters.
Very interesting! Love the chat on mental health medication during pregnancy and postpartum. Dr. Waggel is super knowledgeable in this area.
Exactly 💯
You need hormonal balance and start with Vitamin D3 and the K2 and full protocols for uptake......Plus the B vitamins but proper form which is not over the counter commercial products at the grocery store or walmart. So get the D3 levels up and Nordic Cod Liver Oil is good for a source and a multisource of nutrients. BUT this comes to HUMAN GROWTH HORMONE and the Pituitary gland and how HGH tapers off with age. SO the Vitamin D3 will involve numerous functions in the body but the main one in focus is the SLEEP CYCLE AND RESTORATIVE SLEEP CYCLE....if you don't get to the stage of sleep where the body goes into repair mode....then you AGE ! So the D3 gets you restoration rebuild over night phase.....and if you have created a huge backlog......it will take time to catch up so i may not be over night nor a week away. SO Hence HUMAN GROWTH HORMONE.....and the FASTER BODY MECHANISM TO REGENERATE TISSUE AND CELLS.....so once the D3 level come up in the testing....then the hormonal balance comes back up and then the action of HGH.....and you turn the time clock back...... AND GET AWAY from Processed Foods without nutrient content you need and all kinds of substitute crap that robs health and injures the digestive tract and the gut biome
So lots we still don't know. I'm not a nutritionist so I'll defer that specific advice to an expert in that area
@@carriepaglianopt research Dr. Stashia Gominak as she is a neurologist MD and was writing the book on vitamin D3....her presentations are usually an hour long or more....and she does seminars
I think you're definitely on to something. I'm new to this channel and caught this video of yours. It's alarming how little help I've been able to find with my issues. Though I'm about to start pelvic floor therapy very soon so now I'm interested about what will come of this experience. I think if you add to the mix a patient like myself with PCOS and endometriosis headed towards perimenopause it might get even more complex. Estrogen seems to be causing cramping for me and then leading to pelvic floor/SI joint issues.
Endo & hormones are a huge conversation I have with clients. Usually the muscle piece can be responsive to what's going on with pain/hormones management.. best bet is a collaborative care team!
Pink pear sponge is ok. Doesn’t press into rectum/rectocele as much
Not a clue what you're talking about but hopefully it's not a kitchen 🧽😂
@@carriepaglianopt lol pink Pearl sponge. Some women use it as a pessary and also for menses. They have a website you can check out. For me it was a lot more comfortable than other pessaries. Thoufh it’s not without fault
I got my pessary at a urologist.
That's great!
This might work for me. Thanks
Great!
Yep. I agree 100%. I am on HRT and have noticed a huge difference in muscle tone and in my pelvic floor as well.
Mi az a HRT?
That's awesome! Glad you had that option!
Will pelvic therapy help? I had a mesh put in about 3 years ago? My urologist advises me to go.
Definitely worth an assessment
Will pelvic therapy help with incontinence after getting a bladder mesh?
Definitely worth a check!
Tried a pf therapist , got my 3th daughter. Leakage...Got into mutu system. Didn t do much. Divorced. Moved. Got to a PF therapist again. Not much result. Discovered that my PF was over tense and was not able to relax it. Went to my GP, went to gynacologist. Who tought about tvt sling, but my bladder was too weak for that. Went for a second opinion. Same conclusion. Went to a commercial plastic surgeon. She noticed a mild prolaps. Said it should/ could be fixed under health insurance in the regular hospital. Regular hospital refused, since its too mild. A few days ago, i saw a explainer on YT, the prolaps can cause weight on the PF , so it cant relax...so the PF can't be trained.... My daughter is 12 yo now, i spent hundreds of euro s on programms... and i'm not where i want to be...
I'm sorry. How we understand Prolapse has changed A LOT in the past 20 years. High tone and POP are a newer consideration. Need to address what's contributing to the high tone but also dampen the sensitivity to the mild POP
I'm a 54 year old woman I've had 2 pregnancies and 2 vaginal births...never lost bladder control ever. I'm a stop and start urinator. At least 1 pee a day. Always. I do notice the more weight I put on on my stomach the weaker my bladder is. I can sneeze/pee when I'm holding weight. I also listen to the sound of my pee. If it comes out in a tinkling sound I'm good....if it comes out as a funnel sound I have bad bacteria in there and do a vaginosis treatment. Listen to your bodies ladies
Glad you & your bladder are friends❤
DM on what platform?
@carriepagliano on IG
It’s sad to see women are getting the cube, which is supposed to be removed nightly, and they are being told it can be left in for days or weeeks
Correct, it needs to be removed for cleaning. Education regarding proper care is paramount!
@@carriepaglianopt I’m in a group on FB called pessaries and pelvic organ prolapse. You would probably be appalled at how many women are fitted with a pessary and leave with no instructions to insert and remove it, and some get it placed and their providers don’t have them come on for 3 months to get it checked. The first pessary! There are at least 2 women now in horrible pain. Can’t remove the pessary on their own and have to wait weeks to get into their providers! It’s a travesty!