Affording Pelvic Floor Treatment on a Limited Budget

affordable pelvic floor therapy
Dr. Riva Preil with a patient on the Upper West Side, NYC

The Real Cost of Getting Care

Treating gynecological pain is challenging. First, there’s receiving a proper diagnosis, which is often not an easy feat. Next, there is putting together the right medical team. And then, if this wasn’t hard enough, there is figuring out how to pay for it all.

That last part can be the most frustrating. It’s something I touched upon in a prior  blog post, and it’s something that’s fortunately being addressed in the news recently: The Guardian recently profiled Jennifer Vargas, a 35-year-old woman who has shelled out, to date, about $15,000 to treat chronic vaginal pain. That’s a year’s worth of rent in some states!

Why Does It Cost So Much?

So why is it so expensive?

Well, for starters, not all providers will take your insurance. And while it is easy to say, “Just go to someone who will,” you need to have a special rapport with anyone who treats such an intimate part of your body, particularly a gynecologist or pelvic floor physical therapist. You are also seeing them more often than most providers. So while you may be able to ignore it if your in-network dentist is a little short with you during your annual visit, that can be harder to do when you are seeing a pelvic floor therapist for months at a time.

And the fact that you are seeing them so often is another reason why the cost adds up. It could cost several hundreds of dollars a month alone, just on physical therapy, if you can’t find a competent in-network provider.

You may, like Vargas, need to see more than one provider at a time. Or maybe you need medication, surgery, yoga, nutritional guidance and dilators. You may need need to travel, as patient SB who had pudendal neuralgia did. Or maybe you need to pay for childcare while you receive treatment.

On top of that, many with pelvic pain are unemployed or underemployed because they are unable to work or are very limited in their work abilities due to their medical issues and pain.

The Good News: You Have Options

But I’m happy to report there are ways to help you access the care you need and deserve, regardless of your income.

Talk to Your Therapist About Your Budget

First of all, don’t be ashamed to tell your therapist you’re on a budget. Yes, ideally, they may want to see you more than once a week at the beginning, but they might be able to space out appointments and work with you on creating a schedule that fits your budget. You can also do homework with dilators to stay on track in between sessions.

Ask About a Payment Plan

If your therapist doesn’t take your insurance, you should inquire about a billing plan. They may be able to work something out or offer a sliding scale option. Of course, it is never comfortable to discuss money, or lack thereof, and no one wants to be anybody’s “charity case.” But that is not how your physical therapist views it. Your therapist became a therapist because they want to help you get better. I often say in the course of these conversations with patients that I didn’t choose physical therapy to get rich. You know, I would have become a finance bro if that was my goal in life! I became a PT because I genuinely want to make a difference in people’s lives and help them feel better in their own bodies.

This Conversation Should Never Feel Awkward

These conversations shouldn’t be awkward. If they are, and if your PT doesn’t make you feel safe to be vulnerable and raise this topic, you may want to reconsider your choice of PT.

Check Your HR Benefits

If you are employed, inquire with your company’s HR department if there are any stipends allotted towards healthcare. Sometimes your company will provide reimbursement if you show them a receipt. Your therapist will be more than happy to provide that.

Consider Care Credit

Care Credit is a credit card you use to pay for various forms of care, like physical therapy. You pay monthly, so it is less overwhelming.

Save on Medications with GoodRx

GoodRx can make medications more affordable, up to 80%! Coupons are free and accepted at pharmacies you’re already using, like Walgreens and CVS. It’s not health insurance, so you don’t need to apply through your job and your income is irrelevant.

Don’t Skip the Superbill

Superbills are an important part of the insurance process that a lot of people are not familiar with. Even if a provider is out of network, you can submit it to your insurance company. If you have out of network benefits, you may be eligible for reimbursement.

Look Into the Aziza Project

The Guardian highlighted how the nonprofit Aziza Project is helping fund some medical costs for people with complex gynecological problems, so it’s worth looking into, especially considering that they offer free, remote consultations.

Take Advantage of Free Consultations

If you are at the beginning stage of your journey and are unsure about which pelvic floor therapist to go to, take advantage of free phone consultations so you don’t waste money on a therapist you don’t vibe with. This is a service I am proud to offer.

The Bottom Line

It’s easy to feel overwhelmed when you realize how expensive pelvic floor healthcare costs. You might decide it’s easier and more economical to simply live with the pain. But remember that untreated pain has costs too: lost workdays, more money spent on pain medications, missing out on special events.

Yes, it takes a lot of effort to determine how to best afford pelvic healthcare, so much that it can feel like a second job. But the work is worth it when you consider how priceless the end goal is. And, you deserve to feel great in your own body and to live your beautiful life to the fullest.

 

What are Kegels?

The Key to Kegels

What are Kegels? Put simply, Kegels are to the pelvic floor what yoga is to the body, mind and spirit. They are an accessible form of low-impact exercise that has the potential to dramatically improve your life.

To get even more granular, “Kegel pelvic floor exercises are used to strengthen the muscles that support your uterus, bladder, bowel, and rectum,” according to WebMD. Kegels have enjoyed some publicity as of late, being touted as a way to treat erectile dysfunction and achieve pelvic floors of steel.

So how do you do them?

Many of us are not aware of where our pelvic floor muscles even are, so engaging them can be a challenge. 

There are several ways, per Healthline. One is to simply replicate the experience of holding in gas. If you attempt that and then feel it in your vagina or back end, you’re doing it right! You can also locate these muscles by stopping urine while on the seat or putting a finger inside yourself while doing the exercise to feel the pull. Although please do not get in the habit of doing this routinely, as it sends mixed messages to your pelvic floor! You get one shot at it, for educational purposes only!

If you are of a certain age, think back to those claw arcade machines you played with as a child. The Cleveland Clinic compares the motion of a Kegel to the claw opening and closing around a prize. 

You then will tighten your muscles for a count of five, and relax for the same count. For optimal help, perform these endurance contractions 20x, three times per week. You can also perform Quick Flicks, or “fast exhale squeeze, fast inhale release” 50x, three times per week.

Your physical therapy appointment is another great time to check your Kegel form. You shouldn’t be embarrassed or feel like you are bothering your therapist. That’s what they are there for!

Now, let’s take a closer look at what they’re for.

Pelvic Organ Prolapse

As I explain in my book The Inside Story, “POP is associated with the excessive descent of one or more of the pelvic organs or the vaginal wall.” It can happen after childbirth, and there are several different types of prolapse. These include uterine or cervix prolapse, cystocele/anterior prolapse, rectocele/posterior prolapse, and rectal prolapse. I also talk about prolapse in this blog post – well worth the read! Pelvic organ prolapse has a number of treatments, ranging from a pessary to surgery, but Kegels can make pelvic floor muscles stronger and those are the muscles that keep those organs stable. 

Incontinence

Pelvic floor muscles affect how much control we have over our urination and defecation, which is why it may be recommended to strengthen them to treat urinary, urge and fecal incontinence

Better Sex

Now I’ve got your attention! Yes, Kegels can even help in this department. According to WebMD, there is scientific evidence that Kegels can “enhance female sexual arousal by relaxing the vagina, improving lubrication and allowing more blood flow to the genitals.” In men, they may heighten the pleasure of orgasm and provide “greater control over ejaculation.” (Pelvic floor muscles really are the center to so much that goes on in our bodies!)

Who Shouldn’t Do Kegels

Kegels can be a problem for people with a hypertonic pelvic floor. This means the pelvic floor muscles are unable to fully relax. Nebraska Medicine states, “While these exercises may benefit both men and women, performing too many ─ or performing them incorrectly ─ may increase muscle tension and pain, or worsen your symptoms.” One journalist received a hypertonic pelvic floor diagnosis simply from doing Kegels alone, so you have to be careful. They also provide very limited benefit for overflow incontinence.

As usual, it is best to speak with a healthcare provider. 

Also, have patience: Don’t expect overnight success as they can take up to a few months to work. Try adding Kegels to your Google calendar or doing them first thing in the morning. You can even pair them with your favorite podcast to help make the habit automatic. And the result is not only a stronger pelvic floor but stronger relationships, less embarrassment, less pain, more pleasure – overall, a pretty big impact for such a really tiny movement!     

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732-595-1DPT (1378) | riva@revitalizephysicaltherapy.com

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