I hope this will be useful and is written from my experience as a 52 year old woman, who loves being a physio., mostly working with people who have or have had cancer. I am enormously indebted to the people who have trusted me with their precious bodies and minds and who have taught me so much.
Abdominal surgery, radiotherapy & chemo can have a massive impact on the person with a cancer diagnosis and also on those who love and care for them.
It’s common for people to describe themselves as ‘disfigured,” or “unattractive,” be wary of touching or looking at their tummy,** not always have a full understanding of what exactly has been removed, replaced or affected and unsure whether to hope I can help or not.
Fascia is a connective tissue just under the skin. Around the muscles, in between the muscles and amongst our organs. Around nerves, blood vessels and lymphatics, becoming periostium, the outer layer of our bones – it’s almost everywhere in the body! It embraces the muscles so they can work efficiently and when we move, structures can slip over one another smoothly.
When we have surgery, an injury or radiotherapy, the fascia can be scarred and get stuck – you may know someone who has had painful adhesions, someone with altered bowel movements, tightness in their legs, has developed a “bad back” or even tight neck/shoulders after abdominal surgery These things sometimes happen because the fascia is an extensive system, throughout the body and if it gets stuck in one place, other parts of the body will have to compensate. A jam on the motorway can have impact in other parts of the country!
“Hands on,” treatment can make an enormous difference to the feel and look of scars. Importantly for some people, it can be healing to have someone interested in their scar and keen to work with it. Not repulsed or scared by the changes.
It interests me to see how often the person’s “heart” seems to heal as their body responds to treatment and their outlook stretches: optimism, hope and dreams start to re-emerge. Bowel function and sleeping may improve and other parts of the body restricted by the scar tissue move more freely.
As I am confident to treat the person’s body, that can improve confidence at home, either with sexual or sensuous expression or with vigorous “messing about” with children or pets.
Intimacy encompasses a broad spectrum and for some people, using a pH balanced vaginal lubricant maybe useful (I am not allowed to recommend brands as a physio, but I hear that Yes, Yes, Yes is popular + apparently safe for oral sex)
Sam Evans, who I “met” on Twitter, shared the Jo Divine health brochure with me which some people have found useful – and they open up the conversation, if the person wants to have it! I’m frequently shocked to discover that I’m the first health care person to ask…
I have known several people who have found a silky playsuit can be useful as it can allow good access, but also some covering of the body. Pretty lingerie isn’t a hospital accessory, either.
If your surgery has not been via the abdomen, but all internal, you may still have scarring that would benefit from treatment and some Women’s Health physios will be able to do this for you. Radiotherapy can also cause enduring changes in the tissues which may benefit from treatment. Sam and others with expert knowledge of sex toys may be able to advise you better than me on which vibrators etc may be most useful (and maybe fun,) for you.
Exercise (movement and stretching), breathing well, eating and sleeping well and relaxing are important, but maybe not as important as choosing what it is you really want.
Looking after the pelvic floor muscles is really important – they are the bottom of our pelvic basket and can work in harmony with the abdominal muscles. There are lots of adverts for incontinence pads, but please, if you have any leaking of urine or faeces, when you are laughing, coughing, sneezing, bouncing etc get your GP to refer you to a Women’s Health physio to teach you how to do these and check that you are doing them effectively. (When you are passionate about Women’s Health issues, you just want everyone to be continent and having the best sex life they want so it’s not an embarrassing topic for us)
Over the years, I have found that people who have had more than one episode of surgery, had radiotherapy, had lymph nodes removed or have had wounds that are slow to heal or have been infected are more likely to need “hands on “ treatment, so if you have previously had say a C-section or your appendix removed, or a joint replacement or breast or heart surgery, that may be relevant to you – but not necessarily. I write this to share my experience, not to keep anyone awake with worry.
Lastly, I see lots of very vulnerable and sometimes smelly scars under people’s tummies – we sit so much in our culture, it’s not easy to see the area and it may be numb, so please take care with dabbing dry after washing and check for bites with a mirror.
Please feel free to email me at www.leahthephysio.co.uk if you think I can help or you can teach me something. Thank you.