Unable to sit, stand or lie down for any length of time without intense pain, Patti Mendoza needed help.
She originally thought the pain she was experiencing on her pelvic floor and into her abdomen may be a urinary tract infection that hadn’t cleared up. Or, it could have been related to an emergency colon resection she had undergone two years prior that had left her with some gastrointestinal issues.
For most people, discussing either with a physician would be unpleasant. Maybe even a little embarrassing.
For Mendoza, that didn’t matter.
“The pain was so intense it felt as though there was an electric current running through the pelvic floor area,” Mendoza said.
After several tests, doctors discovered adhesions from previous surgeries that had caused a condition called chronic pelvic pain. Mendoza’s physician prescribed a medication to help with the nerve pain, and a team of specialists recommended physical therapy.
“I just wanted relief from the pain and to regain a semblance of normalcy in my life,” the now 69-year-old Schererville resident said. “I do know women who would have been reluctant to discuss this issue, but I have always operated under the premise that whenever I have had a medical issue, I needed to do whatever I could to help the medical professionals help me.”
Though patients typically want their health issues remedied, doctors say many can't get past feelings of embarrassment or even shame.
Dr. Michael Allen, an OB-GYN with Women’s Health in the LaPorte Physician Network, says patients can be very reluctant to ask questions regarding their health.
“As physicians, we want all patients to step up and ask these tough questions,” Allen said. “In doing so, patients are taking charge of their health.”
In his field, some pregnancy-related questions may be easier than others to ask and are common, but he says less straight-forward questions can be uncomfortable for patients.
“We care for women from before the reproductive years until well after their time for having babies,” Allen said. “There are going to be questions that arise within that timeframe that may be uncomfortable to ask.”
He lists questions that revolve around menopause, urinary incontinence, and what is and isn’t “normal” in the bedroom.
“I once had a patient who was uncertain of whether her question for me was going to be appropriate,” Allen said. “My advice to her was that a question is always appropriate when it concerns the health of you or a loved one.”
Sometimes a patient will be so embarrassed that he will fabricate other symptoms to make the appointment, says Dr. Kiran Bojedla, a family medicine physician with Advocate Christ Medical Center in Oak Lawn, Illinois.
“I can’t tell you how many times where someone will come in for back pain, but then they say they’re really there for another reason, such as erection problems or rectal bleeding,” he said.
Mental health, domestic violence and child abuse are other issues that give patients pause. Physicians are trained to look for the warning signs of these situations, Bojedla says, but getting patients to open up can be difficult.
“Whatever the reason they came to the doctor for, they shouldn’t be afraid to ask their doctor,” he said. “We’re not going to do anything with the information except try to help them.”
With younger patients, in particular, that can be especially challenging, because teenagers and children are often afraid of getting in trouble.
“I usually say ‘we’re not cops’ to my younger patients when it may involve drugs and alcohol,” Bojedla said. “Everything is confidential with your doctor. We can’t go to Facebook or Instagram. Our governing bodies monitor for that, and you can lose your license.”
For Vicki Stenulson, manager of outpatient rehabilitation services at the Dyer and Hammond Franciscan Health locations, sex can be one of the most difficult subjects for patients.
Stenulson, who provided physical therapy to Mendoza, notes that everyone has a different comfort level.
“Those with pelvic pain usually have pain with sex, affecting their relationship with their significant other,” she said. “Those with incontinence have a lack of control, and may avoid sex due to fear of leakage. Many are not comfortable talking about their sex life or lack of sex.”
However, thinking symptoms will go away on their own can lead to chronic issues that are more difficult to manage.
“Many women, in particular, just assume that urine leakage especially is normal as they age and after birth, so they just accept it,” Stenulson said. “But, although it is common, it is not normal and it can improve with treatment.”
Those chronic issues can affect a person’s physical and emotional well-being, she says.
“I think anything that impacts their ability to be social or affects their personal relationship should be discussed, because both of these affect our overall health and can lead to other issues,” Stenulson said. “Isolating ourselves, or problems in our relationships, causes increased stress to our bodies, which can contribute to other health issues.”