Recently my coworkers and I celebrated a male patient’s recovery from a long and difficult journey with persistent pelvic pain. “Ben’s” case had many elements of what we normally see in our patients: chronic muscle holding, restricted fascia, allodynia, hyperalgesia, castrophizing and kenisiophobia. Ben was also very upfront about how his pain impacted his emotional well-being and vice versa. His healing process taught us a lot about the biopsychosocial aspects of treating persistent pain. Along his journey we dreamed of the day we could write a blog together and help other people learn from the experience. Ben also decided to make a career change entering school to become a PTA so that he could help others in pain. Here is my interview with this brave patient.
1. Tell us about how your pain started
My pain started with urethral burning. Tests showed there was no infection. In retrospect, the cause of pain could have been the beginning of tension on pudendal nerve branches from extreme stress and a series of traumatic incidents that happened within weeks of each other. They included a very embarrassing and stressful summer of unemployment, a father who had heart failure and triple bypass in the fall, and a girlfriend who gave me an ultimatum when I was too stressed to get an erection.
2. What medical tests or treatments were done?
When the pain started, I first thought it was a basic urinary tract infection. I went to the med center and was prescribed an antibiotic. After 3 days without change, I went back in and although they still found no sign of infection, they prescribed an additional antibiotic. The urethral pain never stopped and seemed to get worse. Following a series of visits to numerous doctors and urologists, I repeated tests on the prostate fluid, blood tests, and more bacterial tests. No infection. My PCP also made a fairly large overture of testing me repeatedly for HIV. For five months I had a blood test every month, all came back negative. This was damaging to my psyche. For those months I was terrified my life was over. In retrospect, that doctor was out of line, I changed doctors.
3. What were your thoughts when your doctor suggested physical therapy?
When the doctor suggested pelvic floor physical therapy, I was a little skeptical because I was still convinced that something was wrong in a chemical or infectious way (as is typical for most men with pelvic floor dysfunction). However, desperate to take away the constant pain, I followed the advice.
Stay tuned for part two of our conversation with Ben, coming up in our next post on the Pelvic Rehab Report!