Kim (00:01.438)
Welcome to another episode of Between Two Lips. I'm your host, Kim Vapni, the Vagina Coach, and this week's episode, we are exploring part two of my PRP adventure. So the last episode, I talked about how I even ended up down that path, talked about my meeting with Dr. Shaberi, my podcast interview with him, my in-person meeting with him, meeting Dr. Jessica Probst at Thrive Physical Therapy and Dr. Siddiqui at Rosam.
going through the treatment of PRP and the recovery process of that first appointment. And the recommendation is that you go for two, at least a minimum of two treatment sessions. So in this episode, I'll explore that follow-up session. So that happened at the end of November. So it's about two-ish months apart. And where I'm at now.
The person who originally introduced me to Jessica and Dr. Siddiqui, she declined an opportunity to join the podcast, which is absolutely fair. I can tell you she has gone for five treatment sessions and she has... It's given her quality of life back. She... It has absolutely changed her life and I am just so, so happy for her that she has experienced this.
And again, I believe that this is such a powerful treatment that could help so many others as well. It is expensive. It's the time of going there. It's the travel unless you happen to live in Washington, DC. And again, the cost. So it's not accessible for everybody. And I do hope that some point down the road this becomes much more accessible for more people. But it is currently a private pay. Maybe someday we even have insurance companies that would pay for this. Wouldn't that be awesome?
So my second follow-up, very similar in the sense of meeting Dr. Jessica, having a very thorough evaluation and treatment. And she, I didn't have her partner with us this time, it was just Jessica. She we have a conversation and at least initially about what changes I've noticed. We'd sort of ranked what sort of percentage I felt there was an improvement on various things. The squish was the biggest change for sure.
Kim (02:24.322)
And then she did a treatment session trying to get my pelvic chloremin the best state possible for going through the next level of treatment with Dr. Siddiqui. She worked a lot on my obturator internus, which is very tight and that's very common in a lot of people. And yeah, it was it was pretty uncomfortable actually. Not that there are some parts of pelvic therapy that are not super comfortable and she was really wanting to
me the most benefit I guess and did a lot of work and at one point I said to her you know what I think I've reached my capacity and she's like all right done and she was very respectful of me reaching the point where I felt like you know what I don't want this anymore and she stopped and we had a conversation we got ready for the next the treatment session in a couple hours and it was great I absolutely adore her she is incredibly
passionate about what she does. She's an incredible therapist. She has so many tools under her belt and we just had such great geek out conversations about bodies and pelvis and movement and all sorts of things. So, uh, I loved it, even though it was uncomfortable and I reached my limit to my capacity. She, she's awesome. And I, and I wish that I was closer by, uh, cause, cause she just was, she was so great. And then
It was interesting actually after that treatment, as I was putting my clothes back on, I felt like the beginnings of Proctalgia Fugax. I haven't done an episode on this yet, I will. Proctalgia Fugax, crazy name, is basically fleeting rectal pain. And this is something that I had started to experience probably five or six years ago. Out of the blue, just showed up one day, and it just, that's what it does, just shows up randomly. There's never really a...
least that I have been able to notice in my own body, nothing that really instigates it, just sometimes it just shows up and I can feel the start of it. It's like this deep ache. And after the treatment, as I was putting my clothes on, I thought, oh, here we go. I feel like I'm going to go into a bit of a flare. And I told her about that and I was able to calm it down. It didn't progress. And sidebar, I was really thankful that
Kim (04:40.146)
I had experienced these before I had my rectocele surgery. Otherwise I feel like I would have associated with my rectocele repair, but these had started well before my rectocele surgery. Anyway, it was able to calm down and it didn't progress anything. So then I just, I had about an hour or so to wait. I went and got something to eat, walked down to Dr. Siddiqi's office, did the blood draw again, and then...
went into the treatment room, saw Dr. Siddique again, Dr. Jessica came down, and again, there was an assistant in the room. Same thing, reporting on findings, asking how I was feeling, what sort of changes I'd noticed in my body, and then went back to exploring the different sites. So the cool part was...
some of the sites that he had injected the first time where he was, he re-evaluated all of those with the ultrasound and there were some, you could definitely see the change. There were some that there wasn't a ton, but there was also a lot where it was, he's like, no more treatment needed. It looks amazing, the tissue's awesome. So it was cool for him, for all of us to see the change that happened in the span of that two months because of that first treatment session. And so he explored
different sites and made his analysis of where he was going to be doing the injections this time. The very first treatment session I had with him in September, some of the most painful injections for me were the ones right by my pubic joint, kind of where my rectus inserts and attaches right at the front of my pelvis. And so I was really apprehensive about those.
this time just because I knew they were, they were the most painful I had. And during one of them, the injection, it was almost like, uh, it was, it was painful as it was injecting. And then all of a sudden it was like a very sharp, intense pain and it sort of made me yelp a little bit. So I was feeling quite apprehensive about that location being injected again, but they did sense and see that it would benefit from a little bit more. And overall, I felt like the second treatment,
Kim (06:57.67)
session was actually more painful. All of them were more painful than the first and I don't know if it was because I was because I knew because I was expecting the pain and I knew that was happening that I was a little bit more tense maybe. I don't know if it was because I had a very you know really in-depth treatment session before with Dr. Jessica. I don't know I don't know why it was it seemed more painful but it was and
Um, so it was the same in terms of they inject the anesthetic, then inject the PRP multiple different sites around my SI joint, around my pubic joint, all sorts of different spots around my velvet addressing pelvic floor muscles. All of that was the same in terms of immediately afterwards. Same thing. I felt stiff. I felt a little bit restricted in my, my gait. Uh,
I didn't have far to go for my hotel. I just kept, you know, laid low. Felt pretty much the same, very achy, not enough that I needed pain medication, at least initially. Later on, I felt like the pain was a little bit more intense and I did take some Tylenol. I felt like the Tylenol didn't do a whole heck of a lot so I didn't continue on. I don't want to take that stuff unless I absolutely need it.
So I didn't feel really much benefit or change from it. So I just didn't take any more after that at all. So I felt like I was a little bit achier, not immediately after, but a little bit later in the next day. Again, the next day I was on an airplane and going back home and same restriction, two weeks, no exercise, no nothing else. I was able to, you know, use my vaginal estrogen and moisturizer.
That was all fine to do, but no rigorous activity. And now here I am. Let's see, this was at the end of November. So it's been about a month since the last treatment. And it's been about two weeks or so that I've been back to exercising. And we had Christmas, my basement where my office is was being renovated.
Kim (09:18.378)
So I didn't, I actually didn't go back to a huge amount of movement right off the bat because I didn't have my normal gym close by and it was busy time of the year and being here managing a renovation. So I feel like the first time I probably went back a little too intensely too quickly and this time I was definitely more gradual in terms of my return to exercise. So the first time I started to get that achiness in the pubic joint as I talked about that was not necessarily.
uh it wasn't the right after the treatment but later on I started to notice that I had some adductor left adductor in particular so inner thigh almost felt like a bit of a strain and some pubic joint tenderness and what Jessica thought sort of hypothesized or speculated was when she treated me that second time when I went to see her at the end of November she said my SI joint was really off.
and she speculated that because of that there was pull down in the inner thigh on the side as a compensation as well. So that made total sense to me. At the end of that treatment, I forgot to mention she gave me, um, or sorry at the end of this treatment, I haven't got there yet, she gave me an SI joint belt to wear and suggested that I wear it for the two weeks as part of my recovery. So I would say I probably wore it religiously for about a week and a half, maybe not the full two weeks.
And so the pubic joint pain that I had started to experience that first time once I got back to movement has not happened now. I don't have this sensation of straining in my inner thighs. I don't have the tenderness around my pubic joint. I don't feel the ache there that's gone. The this squish I wouldn't say I've noticed much change from the first to the second but the change from the you know
before to after that first session was really remarkable. So I didn't feel like, well, I guess I did think that maybe it could be totally eliminated. And it almost is like it's very barely, hardly ever there. So I would say there's been more improvement there. The other piece that I've noticed for sure is the, with insert of sex, I feel like there's more of a hug that happens. I feel like I have a bit more sensation.
Kim (11:44.362)
And from an orgasm perspective and like a stimulation perspective, I felt definitely more. There was like a heightened orgasm for sure. I always had pretty good orgasms, but this I feel like they got better and I felt like I had more arousal almost. It was more. What's the word I'm looking for? More sensitive, I think. So that changed.
SI joint wise, I haven't been able to test this yet, but with certain activities, this is before the first treatment. So before, when I would do things like maybe a one leg deadlift, I would notice a little bit of discomfort on one of my SI joints. And I didn't notice that it changed all that much after the first time, but I haven't been able to test it yet to see if that has changed with the second one. So that is to be determined.
And the heebie-jeebie, haven't explored it too, too much. Partly because it basically the heebie-jeebie sensation for me is if, whether it was my husband or pelvic physio had their fingers right at the opening, not in and not out, but just kind of hovering there. And that really drove me crazy. So it's not the active insertion that bothered me. It was the lingering at the opening. So.
It's not like I miss or ever really did a lot of lingering before, but it was just something that I just noticed that I hadn't experienced that before I had babies. So don't know yet if that one's gone or still there. I don't think that it's going to be totally gone, but might see some improvement there as well. And having done a huge amount of high intensity activity again, it's only been a couple of weeks and.
in that time it's been putting my office back together and then Christmas and New Year's and all the busyness that goes around with the season. So I haven't had enough time to really see if there's much change with regards to, do I still feel vulnerable? Do I feel like I have more support? Given what I felt from an insert of sex perspective, I think that I will and I will report back on that. But that's where I'm at. So.
Kim (14:04.406)
That's my PRP journey. As it stands right now, again, I don't feel like my symptoms are anywhere near bad enough, and that doesn't even sound like the right word to use either. I don't feel like I have symptoms that need to be addressed so much that I would pay for and go through the discomfort again at this point. Now, maybe at some point down the road, if I was feeling the vulnerable.
sensations coming back or more squish was coming back, I would definitely do it again. Right now, I don't feel a need to go and have a third or fourth or fifth or however many sessions for me personally. At some point, I do hope that there are other pelvic physios who will collaborate with regenerative medicine physicians and start offering this as a treatment. I know I was talking to Dr. Jessica and Dr. Sadiki and asking them if they were gonna be doing training.
this and I think that is their plan eventually once they have more research and patience and experience under their belts I think they would love to see this offered to more people so I do hope that happens and for now I
I think it's worth investigating and maybe at the very least try the O-shot and see if that can help make any change for you. If you're dealing with incontinence that you can't overcome, if you have lackluster sex and not a lot of sensation, if you have a known avulsion injury, again, I don't think that's going to do much from an avulsion, but it could potentially help to some degree because the locations that's being injected is very limited. I don't think it would make a huge difference there.
But you never know. That again also is a cost. Usually the O-Shot is about a thousand bucks. So if I consider that I spent 2000 for what I had compared to an O-Shot, I think if you can, I would do the extra money and do the whole big shebang. But again, I realized that I'm incredibly fortunate to be able to do that. Not everybody has the means or the geographic location to be able to do that. So.
Kim (16:18.142)
I recognize that that's not accessible for everybody. But hopefully in sharing this, it will open up opportunities for more people to get trained in this procedure and potentially cost coming down as it becomes more available. That's the hope. And I think that's it. So with these, and once I have the blog post, I know that there will be a ton of questions that come back that things that are probably I've thought about, but I didn't.
think on the spot to add them in. So I suspect I'll either do an ask me anything AMA episode about it, or I'll just do a third part where I address the follow-up questions that come once I have shared these episodes and posted the blog posts with the images and no images of my vag, but just, there's one of me laying on the treatment table with the four people in the treatment room with me, which is kind of funny, but they were all amazing and just.
Absolute professionals, so respectful, so intrigued also and curious about this and really excited about the possibilities of this therapy for so many things, but specific to pelvic floor, which is, as anybody who's listening, usually you know that pelvic health is very underserved and we have really cool opportunities in front of us. So, so hang on, stay hopeful.
I really think that this is going to be one thing that can change the trajectory for so many people. So thank you for listening. Thank you, Dr. Schaberi. Thank you, Dr. Probst. Thank you, Dr. Siddiqui, Dr. Neva, everybody at the Rossum team and Thrive Physical Therapy. I'm really, really grateful to all of you and excited to share more about this.
And I've also asked Dr. Siddiqui and Dr. Propes to do a podcast episode with me. Hopefully we'll be able to get them at the same time, but if not, I'll do a conversation with each of them so they can elaborate and share more about their experience and talk about some of the other case situations that they have seen with their patients. I think would be really interesting as well. So thanks so much for listening. We will see you in the next episode.
Kim (18:38.146)
Bye.
