I would like to extend my huge thanks to Graham and his wife for taking the time to do a blog on his impressions of Physiotherapy around his prostate surgery and they are keen that other men will benefit from their experiences as they invested a lot of time in finding out as much as possible about the treatment options for his Prostate cancer and at many times this was a frustrating task. Gerard
Before treatment
The shock of prostate cancer diagnosis stimulates a significant number of men to further understand the disease, their treatment options and any side effects resulting from that treatment. It was into this group that I personally joined.
My particular treatment involved surgery having a robotic assisted radical prostatectomy, however, during the course of my research which combined the internet (British sites only) a support group and my hospital staff it became very apparent, very quickly, that a number of treatments necessitated the patient to undertake pelvic floor exercises and that its value should not be underestimated especially after surgical procedure.
During their lifetime men have no need to use their pelvic floor muscles so what are they? Where are they, how do you use them? In the context of never needing to use them the NHS and Prostate Cancer UK publications combined with verbal instructions were not enough to enable me to confidently work them.
By fortunate accident I attended a presentation at The Solihull Prostate UK Support group by a Birmingham Men’s Health Physiotherapist , Gerard Greene who specialises in this area of the body and this disease, for me the light was switched on.
To speak to someone who really understands how to start to use these muscles, what you should feel when you do use them, what other muscles you should not be using and to see them operating via an ultrasound machine was and is very worthwhile.
To obtain the full benefit one should attend physiotherapy sessions before and after treatment. The before treatment sessions consisted of information on how I might feel and potential side effects, an exercise plan, various book titles including The Men’s Action Plan by Craig Allingham , Conquering incontinence by Peter Dornan and Facing The Tiger by Suzanne Chambers which may be of benefit . I also had a second appointment close to treatment date to assess progress.
After operation
By definition after treatment all your decisions have been made, this results in some of the issues now being changed.
One’s emotions tend to be raw. The old life has gone replaced with the reality of now both mentally and emotionally.
From a negative prospective the exercise regime must be undertaken regardless of your emotional or physical state which I found difficult. This is due to the fact it is the only way these physical and emotional states can be improved, therefore any failure to comply is a waste of time and money.
The benefit of specialist physiotherapy has also changed because the patient has the opportunity to explain their various emotions and physical problems to someone who understands exactly what is happening and to gain potential reassurance that it is normal or otherwise under the circumstances you have been through in addition you have the opportunity to reassess your ability to perform the exercises correctly. The exercises consisted of doing both slow and fast pelvic floor contractions initially in lying but then quickly moved on to doing them in standing. Then progressed to adding activities like squatting and lunging and gradually moving on to adding in abdominal exercises like in both of the prostate books. Being able to see the muscles working or not in some cases with the ultrasound machine was very useful and most men I think will find this beneficial.
In closing a final positive aspect of using a specialist Men’s Health physiotherapist is that your exercise programme can be altered to suit your current physical attainments relative to your mental state.
Graham