8 UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE Introduction Wellbeing is analogous to a puzzle, where each piece represents an integral aspect of an individual's overall health and happiness. No single piece is more important than another, and to complete the puzzle, all dimensions of wellbeing must be addressed. In the case of pelvic oor dysfunction (PFD) which is often resistant to treatment, considering the general wellbeing of patients becomes imperative for effective treatment. Healthcare professionals typically specialize and see the body part that they specialize in under the spotlight and it's easy to forget to shift the spotlight to include the whole person in a presenting patient. This makes any intervention offered less effective than it could be. As a physiotherapist working in the eld of chronic pelvic pain, the need to see the whole person who is suffering pain or dysfunction has been driven (5) home relentlessly . The layers of causative factors for a pelvic problem are so complex and interconnected that it is vital to have a system through (13) which to understand it . This system requires a broad-rst and narrowed-down-second approach, and it could be integrated into all patient care. The biopsychosocial wellbeing status and the lifestyle factors that are contributory to a patient’s condition must be considered. The outcomes of the biopsychosocial experience the patient is having (27) may be the cause of pelvic girdle dysfunction . Failing to consider this, will certainly leave any treatment lacking and possibly make it ineffective. The team approach is helpful, because one team member may pick up a critical element that (7) another misses . Medical practitioners know this, but the question is; do they do what they know they need to do? Maybe not always, especially when under time pressure. The construct of wellbeing needs to be unpacked. Richie Davidson called wellbeing a skill. Just as when attempting to perform a perfect golf swing, hundreds of small tweaks and adjustments are required, when developing wellbeing, a series of multiple well-made choices made over an extended period of time are necessary. Integral to wellbeing is the ability to use the pelvic oor muscle (PFM) effectively. The PFM is an often forgotten, small, but crucial and over demanded of muscle. When this muscle doesn’t work, there are so many functions that fall out. Functions which in their (3) absence, make living well impossible . Practitioners who work with patients suffering from problems in the pelvic region, have a huge PELVIC FLOOR DYSFUNCTION HAS A COMPLEX AETIOLOGY AND THEREFORE A COMPLEX SET OF SOLUTIONS AND MINDFULNESS PLAYS A VITAL ROLE IN THESE SOLUTIONS. By Sue Fuller-Good BSc Hons (Physio) UCT MSc (Physio) WITS Physiotherapist with a special interest in chronic pain and pelvic function Sue graduated from UCT and did her MSc through WITS in Orthopaedic Manual Therapy (OMT). She has worked in private practice for most of her working life, concentrating on manual therapy and pain. Her interest in the pelvis, pelvic oor, women's health and the craniomandibular junction (which is often a co-morbidity with pelvic pain) brought her many patients suffering from stress, anxiety, sexual dysfunction as well as sports injuries. She has had a lifelong culture of ongoing learning and has delved into many other elds through her career, including nutrition, yoga and motion control among others. She started practicing mindfulness herself 30 years ago and has been to many places in the East to study. She did her training through the Cambridge Health Alliance and Harvard University. She also studied coaching to upskill herself to serve her patients and help them shift their lifestyles to support their healing and wellbeing. Sue believes that effective treatment demands high levels of presence, active listening, inquiry and agility as well as a tool box lled with techniques and approaches. She believes in the therapeutic alliance as the basis for all treatment. Sue is part of the My Sexual Health Team and lectures extensively through many platforms around SA. She has spoken at numerous global conferences and has just published a book about wellbeing, called The Sweet Spot.
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