February 2020 Newsletter
Midnight Bathroom Trips
How incredibly bothersome is it to wake up multiple times every night to pee? I don’t know about you, but I thoroughly enjoy my beauty sleep and I don’t want anything to interrupt it. Waking at night can be brought about for a number of reasons: drinking too late in the evening, sleep apnea, weakness and/or tension of the pelvic floor muscles, and the list goes on.
A few simple lifestyle changes can make all the difference in minimizing your urinary output in the night. If you have a tendency to frequent certain beverages you’ll want to make sure that you are ingesting them wisely. It’s best to avoid liquids at least 2 hours before bed, especially alcohol. Avoiding caffeine in the afternoon will also cut back on the frequency of bathroom trips throughout the day and possibly into the night as well.
Sleep apnea can also lead to multiple bathroom trips in the night. Oftentimes the body associates waking up with needing to urinate, like it normally does in the morning, so when you wake up in the middle of the night the body is tricked into thinking it needs to go. Being consistent with the use of your sleep apnea machine is essential.
Lastly, any tension or weakness to the pelvic floor muscles can also contribute to those nighttime trips. If you feel that you are waking an abnormal amount in the night, be sure to speak with your physical therapist to start discovering ways to combat this nightly routine.
A few simple lifestyle changes can make all the difference in minimizing your urinary output in the night. If you have a tendency to frequent certain beverages you’ll want to make sure that you are ingesting them wisely. It’s best to avoid liquids at least 2 hours before bed, especially alcohol. Avoiding caffeine in the afternoon will also cut back on the frequency of bathroom trips throughout the day and possibly into the night as well.
Sleep apnea can also lead to multiple bathroom trips in the night. Oftentimes the body associates waking up with needing to urinate, like it normally does in the morning, so when you wake up in the middle of the night the body is tricked into thinking it needs to go. Being consistent with the use of your sleep apnea machine is essential.
Lastly, any tension or weakness to the pelvic floor muscles can also contribute to those nighttime trips. If you feel that you are waking an abnormal amount in the night, be sure to speak with your physical therapist to start discovering ways to combat this nightly routine.
SPT Spotlight
Sima Shalchi, PT, DPT, RYT
Physical Therapist
Physical Therapist
Sima graduated with a Bachelor of Arts Degree in Kinesiology and French Studies from Rice University in 2015. She received her Doctorate in Physical Therapy from University of St. Augustine for Health Sciences in Austin, TX in 2018.
Sima gained interest in pelvic health during one of her clinical rotations. She practiced at a pediatric clinic for one year before working at Sullivan Physical Therapy. Working in pediatrics also made her aware of the challenges faced by postpartum women, and led her to find her passion in pelvic health therapy. Sima is eager to help her patients improve their quality of life and reach their fullest potential, while easily communicating with her patients.
Sima is originally from Houston and has lived in Austin for 3 years. In her free time, she enjoys yoga, dancing, hiking, paddle boarding, and traveling.
Sima gained interest in pelvic health during one of her clinical rotations. She practiced at a pediatric clinic for one year before working at Sullivan Physical Therapy. Working in pediatrics also made her aware of the challenges faced by postpartum women, and led her to find her passion in pelvic health therapy. Sima is eager to help her patients improve their quality of life and reach their fullest potential, while easily communicating with her patients.
Sima is originally from Houston and has lived in Austin for 3 years. In her free time, she enjoys yoga, dancing, hiking, paddle boarding, and traveling.
Guest Writer
Surviving Cold and Flu Season
Cold and Flu season is still wanting to linger around this February. It seems like everywhere we turn another coworker is calling in sick or our child has to stay home from school again. This is my favorite time of year to really hone down on what I feed myself and my family. A nutrient dense diet has the ability to support our immune system and to help us recover quickly if we fall sick.
Top 3 Healthy Immune System Tips:
Avoid Excess Sugar
I understand how difficult it is to walk past the bowl of candy in the break room or to steer clear of the dessert table at a potluck. But ingesting even small amounts (3.5 oz) of sugar impedes the ability of neutrophils to engulf and destroy bacteria for 30 minutes to 5 hours after ingestion. Meaning that mini chocolate bar can put some of your immune cells into a temporary “sugar coma” and can potentially leave you more susceptible to catching a cold.
Stay Hydrated
We are nearly 60% water! Our immune system is reliant on bodily fluids to carry immune cells throughout the body via the circulatory and lymphatic system. Make sure you’re drinking half your body weight in ounces a day (up to 100 oz). If you find it difficult to remember to drink water set reminders on your phone to encourage regular sips. If you find it difficult to leave the desk to refill your water bottle throughout the day, purchase a larger bottle and just fill it once.
Nutrient Dense Foods
Eat foods that are rich in minerals. Dark leafy greens, broccoli sprouts, brussel sprouts, bone broth (simmered with veggies), Redmond’s Real Salt, sardines, salmon, seaweed, nuts and seeds are all mineral rich. Our immune system requires the proper building blocks to function effectively and eating mineral dense foods can help support you during this season.
Varian Hans, NTP
Headwaters Nutrition
headwatersnutrition.com
Cold and Flu season is still wanting to linger around this February. It seems like everywhere we turn another coworker is calling in sick or our child has to stay home from school again. This is my favorite time of year to really hone down on what I feed myself and my family. A nutrient dense diet has the ability to support our immune system and to help us recover quickly if we fall sick.
Top 3 Healthy Immune System Tips:
Avoid Excess Sugar
I understand how difficult it is to walk past the bowl of candy in the break room or to steer clear of the dessert table at a potluck. But ingesting even small amounts (3.5 oz) of sugar impedes the ability of neutrophils to engulf and destroy bacteria for 30 minutes to 5 hours after ingestion. Meaning that mini chocolate bar can put some of your immune cells into a temporary “sugar coma” and can potentially leave you more susceptible to catching a cold.
Stay Hydrated
We are nearly 60% water! Our immune system is reliant on bodily fluids to carry immune cells throughout the body via the circulatory and lymphatic system. Make sure you’re drinking half your body weight in ounces a day (up to 100 oz). If you find it difficult to remember to drink water set reminders on your phone to encourage regular sips. If you find it difficult to leave the desk to refill your water bottle throughout the day, purchase a larger bottle and just fill it once.
Nutrient Dense Foods
Eat foods that are rich in minerals. Dark leafy greens, broccoli sprouts, brussel sprouts, bone broth (simmered with veggies), Redmond’s Real Salt, sardines, salmon, seaweed, nuts and seeds are all mineral rich. Our immune system requires the proper building blocks to function effectively and eating mineral dense foods can help support you during this season.
Varian Hans, NTP
Headwaters Nutrition
headwatersnutrition.com
Research Roundup
Physical therapist: Kegels aren't the answer to all pelvic floor issues
Women with tight pelvic floors don't need to start by doing kegel exercises, which could just make the pelvic floor tighter, says Dr. Joanne Wolf, physical therapist and pelvic floor specialist. She also says that even when kegel exercises are the appropriate solution, about 90% of people don't do them correctly.
Physical therapy can help with constipation, pelvic floor dysfunction
Physical therapy can treat constipation and pelvic floor dysfunction effectively without medication, writes Dr. Judy Nee. Physical therapists using biofeedback to track results for constipation improvement showed an almost 80% improvement rate compared with 22% of those who used laxatives, one study found.
Behavioral changes can help women with urinary incontinence
Behavioral therapies are better than medications in addressing urinary incontinence, according to an analysis of 84 studies that was published in the Annals of Internal Medicine. Patients who used behavioral methods were over five times more likely to report improvement of their symptoms compared with women who received no treatment, while those treated with drugs alone were twice as likely to improve as those who received no treatment.
Exercise therapy for chronic pain might prevent suicide, overdose
Military personnel treated for chronic pain after returning from deployment are less likely to experience adverse outcomes such as alcohol misuse, accidental poisoning or overdose, and suicide if that pain treatment is primarily nondrug therapy, researchers reported in the Journal of General Internal Medicine. Most of those who received nondrug therapy received exercise therapy; other nondrug therapies included physical therapy, chiropractic care, electrical stimulation, massage therapy, and acupuncture or dry needling.
Prevalence, management of heavy menstrual bleeding in teens examined
Thirty-four percent to 37% of adolescent girls experience heavy menstrual bleeding, with the most prevalent cause being ovulatory dysfunction, according to a review in JAMA Pediatrics. The researchers said a multidisciplinary approach should be used in HMB diagnosis and management, and noted that the 52-mg levonorgestrel intrauterine device was significantly better than other hormonal methods in treating teen HMB.
Mixed results on link between talc powder, ovarian cancer
Women who applied talc powder to the genitals didn't have significantly elevated likelihood of developing ovarian cancer overall, researchers reported in the Journal of the American Medical Association. However, the study, based on data from four government studies involving 252,745 women, linked use of the powder to 13% increased odds of ovarian cancer among those who had not undergone tubal ligation or hysterectomy, and for those who used powders at least once weekly, risk was 19% higher than for those who did not apply the powders.
Women with tight pelvic floors don't need to start by doing kegel exercises, which could just make the pelvic floor tighter, says Dr. Joanne Wolf, physical therapist and pelvic floor specialist. She also says that even when kegel exercises are the appropriate solution, about 90% of people don't do them correctly.
Physical therapy can help with constipation, pelvic floor dysfunction
Physical therapy can treat constipation and pelvic floor dysfunction effectively without medication, writes Dr. Judy Nee. Physical therapists using biofeedback to track results for constipation improvement showed an almost 80% improvement rate compared with 22% of those who used laxatives, one study found.
Behavioral changes can help women with urinary incontinence
Behavioral therapies are better than medications in addressing urinary incontinence, according to an analysis of 84 studies that was published in the Annals of Internal Medicine. Patients who used behavioral methods were over five times more likely to report improvement of their symptoms compared with women who received no treatment, while those treated with drugs alone were twice as likely to improve as those who received no treatment.
Exercise therapy for chronic pain might prevent suicide, overdose
Military personnel treated for chronic pain after returning from deployment are less likely to experience adverse outcomes such as alcohol misuse, accidental poisoning or overdose, and suicide if that pain treatment is primarily nondrug therapy, researchers reported in the Journal of General Internal Medicine. Most of those who received nondrug therapy received exercise therapy; other nondrug therapies included physical therapy, chiropractic care, electrical stimulation, massage therapy, and acupuncture or dry needling.
Prevalence, management of heavy menstrual bleeding in teens examined
Thirty-four percent to 37% of adolescent girls experience heavy menstrual bleeding, with the most prevalent cause being ovulatory dysfunction, according to a review in JAMA Pediatrics. The researchers said a multidisciplinary approach should be used in HMB diagnosis and management, and noted that the 52-mg levonorgestrel intrauterine device was significantly better than other hormonal methods in treating teen HMB.
Mixed results on link between talc powder, ovarian cancer
Women who applied talc powder to the genitals didn't have significantly elevated likelihood of developing ovarian cancer overall, researchers reported in the Journal of the American Medical Association. However, the study, based on data from four government studies involving 252,745 women, linked use of the powder to 13% increased odds of ovarian cancer among those who had not undergone tubal ligation or hysterectomy, and for those who used powders at least once weekly, risk was 19% higher than for those who did not apply the powders.
Previously Pregnant Women Needed for Study
Female participants needed for research study observing birth outcomes among women of different ethnic backgrounds in the United States. To participate, you must be 18 years or older, have been pregnant in the past 4 years (regardless of the birth outcome) and currently living in the United states. The survey will take about 20-25 minutes to complete. After completing the survey, the participant will have the option of entering their name for a drawing to receive a $25 gift card.
https://survey.az1.qualtrics.com/jfe/form/SV_bkEdLOZQMjcwAAt
If you have any questions prior to taking the survey, please contact Page.Dobbs@ou.edu.
IRB: 11362
IRB Approval Date: 12/04/2019
https://survey.az1.qualtrics.com/jfe/form/SV_bkEdLOZQMjcwAAt
If you have any questions prior to taking the survey, please contact Page.Dobbs@ou.edu.
IRB: 11362
IRB Approval Date: 12/04/2019
Updates from the Physical Therapy Team
On January 21, Christina McGee met with Michael White PA-C, bowel specialist at Texas Children's Specialty Clinic Austin to discuss collaboration in regards to complex pediatric cases of bladder and bowel dysfunction
On January 24, Lauren Gaspar, MSW, LCSW-S, RPT-S, EMDR Certified, of Good Mourning Counseling Center presented to the Physical Therapy Team on EMDR as a treatment option for patients that have suffered from trauma.
PT Below the Waist Podcast, Jessica and Jamille interviewed Jeanice Mitchell, owner of Integrity Rehab and creator of MyPFM. They discuss pelvic prolapse and myPFM educational program. Jessica and Jamille also interviewed former students, Greta Vogel and Beverly Lopez, about their clinical intership experiences at Sullivan Physical Therapy.
Congratulations to Kimberlee Sullivan who was one of four physical therapists appointed to the American Board of Physical Therapy Specialties (ABPTS) Specialty Council for Women’s Health Physical Therapy. ABPTS Specialty Councils develop minimum eligibility requirements for certification and recertification in a specialty area. Specialty Council members are responsible for developing the examination instruments in consultation with the ABPTS testing agency and approved consultants. In, addition she will continue to serve as a Women's Health Physical Therapy Expert on the Specialization Academy of Content Experts. The Specialization Academy of Content Experts (SACE) was established to create a pool of certified specialists to write items for the specialist certification examinations.
On January 24, Lauren Gaspar, MSW, LCSW-S, RPT-S, EMDR Certified, of Good Mourning Counseling Center presented to the Physical Therapy Team on EMDR as a treatment option for patients that have suffered from trauma.
PT Below the Waist Podcast, Jessica and Jamille interviewed Jeanice Mitchell, owner of Integrity Rehab and creator of MyPFM. They discuss pelvic prolapse and myPFM educational program. Jessica and Jamille also interviewed former students, Greta Vogel and Beverly Lopez, about their clinical intership experiences at Sullivan Physical Therapy.
Congratulations to Kimberlee Sullivan who was one of four physical therapists appointed to the American Board of Physical Therapy Specialties (ABPTS) Specialty Council for Women’s Health Physical Therapy. ABPTS Specialty Councils develop minimum eligibility requirements for certification and recertification in a specialty area. Specialty Council members are responsible for developing the examination instruments in consultation with the ABPTS testing agency and approved consultants. In, addition she will continue to serve as a Women's Health Physical Therapy Expert on the Specialization Academy of Content Experts. The Specialization Academy of Content Experts (SACE) was established to create a pool of certified specialists to write items for the specialist certification examinations.
Upcoming Dates
February 4
UsToo Prostate Support Group: Mike Jones Memorial Chapter will be
at 7pm to 8:30 pm at St.David's South Austin Medical Center.
February 8
Pelvic Pain Support Group 10 to 11:15 am 4131 Spicewood Springs Road Suite M-1 Austin, Texas 78759
RSVP prior to joining the group: brittanyneece@gmail.com or 512-814-6027
February 10-13
Kimberlee Sullivan will be traveling to meet with other Women's Health Physical Therapy Experts to discuss pelvic floor physical therapy at the American Physical Therapy Association Combined Sections Meeting in Denver, Colorado.
UsToo Prostate Support Group: Mike Jones Memorial Chapter will be
at 7pm to 8:30 pm at St.David's South Austin Medical Center.
February 8
Pelvic Pain Support Group 10 to 11:15 am 4131 Spicewood Springs Road Suite M-1 Austin, Texas 78759
RSVP prior to joining the group: brittanyneece@gmail.com or 512-814-6027
February 10-13
Kimberlee Sullivan will be traveling to meet with other Women's Health Physical Therapy Experts to discuss pelvic floor physical therapy at the American Physical Therapy Association Combined Sections Meeting in Denver, Colorado.
PT Below the Waist
Jamille Niewiara and Jessica Chastka are co-hosts of Sullivan Physical Therapy's podcast called "PT: Below the Waist", a patient oriented podcast discussing topics related to pelvic floor physical therapy and how it addresses bladder, bowel, and sexual function issues. The podcast features two pelvic floor physical therapists casually conversing about their experiences and thoughts towards pelvic floor related issues.
Every few weeks, they will be posting podcasts about different diagnoses, tips/recommendations to address symptoms, and interviews with medical professionals. Subscribe to their podcast on iTunes, follow them on Twitter @PTBelowTheWaist, and like them on FaceBook. Leave comments and questions on their email: PTBelowTheWaist@gmail.com.
Sullivan Physical Therapy encourages you to listen to their podcasts and get enlightened about "Better Pee, Better Poo, Better Sex".
To listen to our latest podcast please click here.
Every few weeks, they will be posting podcasts about different diagnoses, tips/recommendations to address symptoms, and interviews with medical professionals. Subscribe to their podcast on iTunes, follow them on Twitter @PTBelowTheWaist, and like them on FaceBook. Leave comments and questions on their email: PTBelowTheWaist@gmail.com.
Sullivan Physical Therapy encourages you to listen to their podcasts and get enlightened about "Better Pee, Better Poo, Better Sex".
To listen to our latest podcast please click here.
Sullivan Physical Therapy & Austin Area Birthing Center
Postpartum pelvic floor physical therapy is standard in some other countries, with health systems recognizing that preventative care during the crucial healing period following delivery can save women from future suffering and save the system hundreds of thousands of dollars in medications and surgeries farther down the line. Problems such as incontinence, prolapse, scar pain, diastasis recti, back or hip pain, and pain with intercourse can be addressed and eliminated or even prevented all together with a post partum evaluation and recommendations or exercises from a pelvic floor physical therapist trained in postpartum health. To this point, these services are rarely offered in the United States.
Sullivan Physical Therapy is excited to partner with Austin Area Birthing Center in creating this type of whole- person care for clients. Christina McGee PT, DPT, will be on site at Austin Area Birthing Center South Thursdays to provide physical therapy evaluations and treatments to pregnant and postpartum AABC clients to maximize health and healing and allow patients to get back to activities safely following delivery. At this time, the only insurance accepted at AABC is Blue Cross Blue Shield, however we will give you a receipt for you to submit to your insurance companies.
Please contact Sullivan Physical Therapy to learn more about this service and schedule an appointment or email christina@sullivanphysicaltherapy.com.
Sullivan Physical Therapy is excited to partner with Austin Area Birthing Center in creating this type of whole- person care for clients. Christina McGee PT, DPT, will be on site at Austin Area Birthing Center South Thursdays to provide physical therapy evaluations and treatments to pregnant and postpartum AABC clients to maximize health and healing and allow patients to get back to activities safely following delivery. At this time, the only insurance accepted at AABC is Blue Cross Blue Shield, however we will give you a receipt for you to submit to your insurance companies.
Please contact Sullivan Physical Therapy to learn more about this service and schedule an appointment or email christina@sullivanphysicaltherapy.com.
