Tuesday, October 9, 2012

Voiding Dysfunction Therapy Session #1

A couple of months ago, Garrett's G.I. specialist referred him to a physical therapist who specializes in voiding dysfunction. The PT office called to set up a schedule of 6 sessions, one per week for 6 weeks. Today was the first one. The therapist was a nice man, but he had to place 3 stickers on Garrett: one on the inside of each rear cheek and one on his left hip. This was the worst as Garrett lost his brain and was horrified and angry and just plain wasn't going to comply. After a half hour of the screaming and resisting, we coaxed him into at least getting onto the table and letting us try. Finally, with stickers/electrodes in place, the PT measured Garrett's pelvic floor muscle responses when he "held poop in" and when he "pushed poop out." When asked to hold it, Garrett did nothing. He said he didn't know how, thus the computer measuring the response showed no change in the pelvic floor muscles. However, when asked to push poop out, the computer registered exactly what the G.I. specialist thought. Garrett's pelvic floor muscles are doing exactly the opposite of yours and mine when we go potty. His tense and don't allow for things to happen "down there" at all. Poor little dude has been mechanically incapable of pooping intentionally his whole life. Now at age 7, we think he may benefit from the therapy, but only time and lots of coaxing back into the "office with the white stickers" will tell. Of course, I feel guilty, not that it is at all about me, except that I have been giving him negative feedback and negative emotions when I continually have issues like the one pictured below:

It has been a guessing game until today. Does he know what is going on with that part of his body? Is this mechanical? Is it behavioral? The scopes he has had made it appear he is structurally normal, at least. But now we know. Garrett's inability to poop on the toilet isn't there. We do hope that now we can move forward with this therapy and maybe help him gain control and thus more independence. He gets so incredibly upset on days when he has poops like the one in the photo ALL DAY. And yes, he tells us he doesn't know when it is happening. Also, one other clue that the pelvic floor muscle response  or lack-of was the issue is that usually when he poops he is in bed before going to sleep. So he is relaxing and then the poop can finally travel the exit route.

Sorry if this is T.M.I for you, but for some other of you, I hope maybe this leads you in a new direction or gives you some ideas or hope! For me, I crawl, and I mean almost literally CRAWL in bed after this long, but wonderful day, and pray for forgiveness for not always being the loving, positive mom that my kid needs!!


1 comment:

  1. KayTar had AD manometry last year (sensor in the bottom to test muscle/nerve function). Her nerves were functioning properly as far as they could tell, BUT she had NO IDEA how to "hold it". They had to teach her how to do it do they could measure her muscle strength. That alone made the testing worthwhile, because until then we didn't know she didn't know how! It isn't a skill you think to teach! She still has leaky issues and sometimes a little MORE than just a leak, but it has gotten better!