Facing Pelvic Pain: A Guide for Patients and Their Families. Elise J. B. De, MD, Theodore A. Stern, MD. Massachusetts General Hospital Psychiatry Academy; Color illustrated paper, 417 pages, $29.99, Kindle $9.99.
Dr Elise De is an associate professor of surgery at Harvard Medical School, staff urologist at Massachusetts General Hospital, director of urology training for female pelvic medicine and reconstructive surgery, as well as director of neurourology services for the Spaulding Rehabilitation Network. Her research focuses on voiding dysfunctions and pelvic pain. Dr Theodore Stern is a professor of psychiatry in the field of psychosomatic medicine/consultation at Harvard Medical School and the author of more than 450 scientific article and book chapters. Both are well suited to compile an extensive guide for patients and their families on pelvic pain. Together, they assembled 45 experts to write a 21-chapter book designed in a question-and-answer format on pertinent questions concerning pelvic pain and its medical and psychiatric/psychological care components.
Topics cover the following: what is pelvic pain; what is involved in an examination; what female and male urological problems can lead to pelvic pain; and what gastrointestinal problems, musculoskeletal issues, neurologic, rheumatologic, vascular, and neuroinflammatory conditions lead to pelvic pain. In addition, for the physical therapist working in this area are chapters that highlight physical therapy, diet, exercise, medications, surgery, and physical disabilities. There are sections devoted to sexual activity and its effect on pelvic pain as well as how to cope and advice to families whose loved ones are experiencing pelvic pain.
The resources are exhaustive from the treatment map, references, and the addition of the Web site for the book, https://www.facingpelvicpain.org, all of which offer much for the patient as well as the physical therapist with videos, webinars, podcasts, downloadable PDF forms, a treatment map, 50-page glossary, and bladder diary. The physical therapy student thinking about going into the field of pelvic health would be interested in the tutorials on urodynamic and cystoscopy videos, which directed to the patient, are clearly explained. The use of color pictures and anatomical drawings enhances the book, although some of the labels are small. Chapter 1 is generously available to read on the book's Web site (https://www.facingpelvicpain.org/book-ex).
The 2 chapters related to physical therapy, "Which Musculoskeletal Problems Can Lead to Pelvic Pain" and "How Do Physical Therapy, Diet, and Exercise Affect Pelvic Pain," are written by leading health care providers in pelvic health physical therapy, Dr Beth Shelly, Dr Cindy Neville, and Allison Snyder. Included are some general pelvic floor stretches, biofeedback display, recommended healthy positioning sitting, desk work posture, and getting objects off the floor, all geared for information for the patient.
The comprehensive and easily readable nature of this book puts it high on the list for all physical therapists who treat pelvic pain as a resource and for physical therapy instructors and students interested in the topics.
-Rebecca Stephenson, PT, DPT, MS, WCS
Millis, Massachusetts
The Fourth Trimester: A Postpartum Guide to Healing Your Body, Balancing Your Emotions and Restoring Your Vitality by Kimberly Ann Johnson. Boulder, CO: Shambhala Publications, Inc; 2017. Paperback Shambhala $18.95. 360 pages. Amazon $13.99; Kindle $10.24.
Kimberly Johnson is a self-proclaimed birth doula, sexological bodyworker, postpartum care advocate, and co-founder of the STREAM School for Postpartum Care. She runs 2 private practice locations in California where she specializes in peripartum preparation and rehabilitation.
This book begins with a description of the author's own experience with a birth injury and the strategies she found that helped her restore her own physical and emotional quality of life. Through these experiences she has grown to understand the paucity of resources available to new mothers. She has used her circuitous return to health and wellness to pave a path so that others may avoid her same experiences and, when needed, know how to seek resources for rehabilitation more readily. Readers are guided to specific chapters depending on pregnancy status, making this a good reference for those contemplating pregnancy, currently pregnant, or anywhere in their fourth trimester journey.
The author addresses the societal pressures for mothers to quickly "return to normal" and the unrealistic and unnecessary stress this places on all members affected by the birth of a baby. She describes the breadth of the still newly coined "fourth trimester" and in doing so, she encourages the reader to question the standard advice for return to normal physical activity, sex, and work frequently provided at the 6-week postpartum medical visit. She compares and contrasts beliefs and support strategies provided to new mothers across the globe and uses these practices to inform suggestions for the reader looking to plan for or restore postpartum vitality.
The book has 3 chapters describing strategies for preparation, leaning into the postpartum experience, and regaining balance in a new postpartum body. Several appendices are provided to prompt the reader to consider the numerous aspects involved in birth planning and to provide strategies for creating a sanctuary in the home after baby is born. She offers recipes to aid with digestion and restore nutrition to assist postpartum healing. Simple exercises are suggested with an emphasis on avoiding return to vigorous exercise before 6 months. Additionally, strategies for mindfulness and self-care are provided to assist the postpartum reader with return to intimacy and self-acceptance of her new postpartum body.
This text may be a good addition to the clinical borrowing library to supplement patient-specific exercise and evidence-based rehabilitation strategies for comprehensive care into the fourth trimester.
-Jennifer Miller, PT, DPT, CLT, WCS
St Louis, Missouri