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2012 Jun;187(6):2113-8. doi: 10.1016/j.juro.2012.01.123. Can anyone please tell me a best estimate for how long until I see results? Would you like email updates of new search results? Started a few weeks later with a pt for pop. url = /blogs/kegel-exercise Clipboard, Search History, and several other advanced features are temporarily unavailable. Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. The means of choice is a precise self-massage, that focuses on the trigger point. Essential Elements of Pelvic Pain in Men and Women Recognizing Myofascial Pelvic Pain in the Female Patient with Chronic Pelvic PainMyofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy, Celeste Cooper, R.N., is a freelance writer focusing on chronic pain and fibromyalgia. Niva Herzig MS,PT Englewood, NJ Core Dynamics PT 201-568-5060, Jamie Besante, PT Beachwood, NJ Southern Ocean Medical Center (609) 978-3110, Michelle Dela Rosa, PT Columbus, NJ (609) 379-0900, Nancy Ely-Maskal, PTA Physical Medicine and Rehabilitation Center Englewood, NJ (201)567-2277. 0330 041 7271 info@paincareclinic.co.uk. Sarton Physical Therapy Patient Testimonials Mindfulness Trigger point therapy isn't "too good to be true" it's probably just ordinary good. I suffer from myofacial trigger points for over 2 years now. This is an article about good pelvic floor PT: https://pelvicpainrehab.com/patient-questions/401/what-is-a-good-pelvic-pain-pt-session-like/. Thanks so much I hope you are feeling better. government site. Any advice you could offer would be much appreciated. Maria Elliot, PT London UK http://www.simplywomenshealth.co.uk/. He has been doing the protocol faithfully without improvement. Below is her information: Hi Anne.So far I have decided no,but have still not discussed with Carolyn. I have two questions. The first and only pelvic trigger point wand covered in a BPA-free, non-porous, easy to clean silicone silky smooth for your comfort. I have trigger points in my leg, back, neck, and shoulder so I believe that old levator ani pain is very familiar and an undiscovered source of some of my chronic pelvic pain. She is lead author of Integrative therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and the Broken Body, Woundedmore, Celeste Cooper, R.N., is a freelance writer focusing on chronic pain and fibromyalgia. Unauthorized use of these marks is strictly prohibited. Not an athlete. Is it likely that she is avoiding it on purpose or is it likely that she just feels that other areas need to be resolved first/more? Journal of Urology, 174(1):155 . Kegel Exercises Wishing you relief and roll on 23rd Aug. Anne, Dear Linda. Here are the therapists we recommend in your area: Emily Wegmann, PT (919) 571-9912 [emailprotected] Carolina Pelvic Health Center, Jennifer Briggs, PT (919) 571-9912 Carolina Pelvic Health Center, Dear Stephanie Can you help me please? Vaginal Discharge Ive been to several gynecologists who all told me it was all in my head, and I should drink alcohol to solve the problem. PDF | On Apr 1, 2005, RU Anderson and others published The Stanford protocol for male pelvic pain: Integration of myofascial trigger point release and paradoxical relaxation training | Find, read . Unfortunately, an evaluation is essential to determine the cause of your symptoms, but from your description, pelvic physical therapy seems to be beneficial for you. I keep my hopes up that I can once again enjoy life without pelvic pain. adjust. 2011 Nov-Dec;27(9):764-8. doi: 10.1097/AJP.0b013e31821dbd76. Fisher's exact test was used to compare palpation responses, ie referral pain, stratified by reported pain site. I mean, i am still tender and use some ice and cushions while sitting but this is so unexpected. Pelvic floor muscle tension and trigger points can be related. Since it is usually difficult to feel these . In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Masters degree in Integrative Health and Nutrition. Relaxation Lay down with a pillow under both knees for 20-30 minutes daily to relax the pelvic floor muscles. Now she wants to do an internal examine of muscles to see if they are stressed. and how do you get to those if buried deep. I have been in pain for 18 months. Thank you~. And lastly, Ill wrap up with a discussion of how pelvic pain trigger points are diagnosed and treated. 6 week check up revealed 3 organ prolapsed. Are there any PTs in my area? Careers. The referral from the urologist had told her that I was having pelvic spasms (as I was) and she assumed that was what was happening. In the 3 sessions since, she has not gone any where near that part of me, skipping over it in favor of focusing on the muscles toward the rear of my rectum where there is a trigger point that I can feel so I know she is working on me, not just avoiding things. Im sorry but without evaluating you to uncover exactly what your pelvic floor impairments are, I can not give you any specific advice about treatment. vaginismus I was diagnosed with Pelvic Floor and SI Joint Dysfunction in my early 30. It went away and stayed away for TEN YEARS only to reappear recently as suddenly as it went away. I always think its best to be honest with your PT. Ive been very triggered by sexual assault plus work is done in noisy clinic where mens voices are easily heard through walls. There are many mechanisms of injury that can cause spasm of the pelvic floor. In Loris case, her pain began after a urinary tract infection followed by a stubborn yeast infection. handle = kegel-exercise Hip flexor group of muscles. My question is do you think that dry needling might be effective as hands on work doesnt seeme to be getting to the heart of the pain. Many reasons for this spasticity have been identified and a specialized physiotherapist has treated me 3 times with internal trigger point therapy. Hopefully the Botox will start soon after that and that my body will respond well like yours has. I had a vasectomy in 2011 and since that time have had increased discomfort starting with testicular pain and then spreading into rectal and abdominal pain. tags = The main symptom for me is urgency ! Im stuck using valium suppositories several times a day for relief. He too is reluctant to look for/treat the trigger point on the bottom of my pelvic floor by the sits bone. Sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: improvement after trigger point release and paradoxical relaxation training. Rebalance Physical Therapy offers trigger point release and other therapies which gets the muscles to release and relax. Why would yoga not be the cause of good pelvic muscle strength? Went to chiropractor (still going), gyny, and PCP, They thought it was my groin. Thank you so much! I am starting to believe this may be a muscular issue with my pelvic floor? Since the BNI, Ive had urgency, frequency, burning urination, perineum pain, tightness, anal pain & really bad anxiety. The bobbled end can also serve as a handle end. My kegel strength was not progressing like pt wanted. I had a bad UTI- confirmed by culture- in August. Myofascial Pain SyndromesTrigger Points by David Simons and Jan Domerholt, Journal of Musculoskeletal Pain, Vol. Dr. has me currently doing bladder retraining as I go to the bathroom 10-12 times a day. Trigger points are generally caused by a muscle being "overloaded" following an acute, prolonged or repetitive incident. I have found that by practicing belly breathing I can get the pelvic floor to relax. Lets have a chat about what we understand is actually going on first.. Do y. Perform MFR after calming severe muscular spasms using techniques such as Strain Counter-Strain or Trigger Point Release. They have not dealt with a case of this there. Pay close attention to aggravating factors such as, sitting too long or on hard surfaces and chairs that cant be adjusted to your body type, over activity, infection, poor posture, or wearing tight pants. Secondly the second physio I saw says trigger points are only when the pain radiates from where she presses (the first physio never said this). Fortunately, pelvic physical therapy is very effective for patients who have had endometriosis. Since that post Ive been going to pelvic floor therapy twice a week, bladder instillations for IC twice a week, and I had a nerve block which confirmed pudendal neuropathy. I have R groin tightness and when receiving chiro. Plus, when I find a trigger point, I always get a reaction from my patient, so Im always tuned into him or her for feedback.. It allows you to massage irritable, tight or sore trigger points in the pelvic floor musculature to relieve pelvic discomfort and pain. I am fortunate to have a urologist who is up to speed with what is going on in this arena and she was able to refer me to a PT who specializes in pelvic floor pain via myofascial release. 2007 Mar;91(2):229-39. doi: 10.1016/j.mcna.2006.12.004. and transmitted securely. Use the wand to guide the muscles downwards and give them a bit of a stretch. Anderson R, Wise D, Sawyer T, Nathanson BH. It is possible your nerve is involved, however, it sounds like there is more going on than just the pudendal nerve. I myself have also been experiencing similar problems with my left lower extremity and pelvic floor ever since a bad ankle injury 7 years ago. Thanks in advance for your help. 2. Int Neurourol J. 4) Pull in your back passage as if to stop from breaking wind - this activates the whole of your pelvic floor muscles and you should feel a slight lift through your wand. Purpose: The vibrating wand is perfect for people with new or chronic pelvic pain, painful intercourse, vaginismus, or proctalgia fugax. Pelvic Floor Physical Therapy, Pelvic Pain, Integrative Nutritional Evaluation & Plans, Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. Ive basically been checked out from head to toe with MRIs and everything looks fine but Im still having problems. The Diagnosis of Chronic Pelvic Pain: How Can We Detect Urological Pain? This site needs JavaScript to work properly. I can recommend a few therapists, depending on your location. That would be great if I could find a physician here in metro Atlanta. I am also more than happy to offer a recommendation. As people get treated they may notice pain symptoms traveling around their bodies. Is there a support group in West Michigan? These include, but are not limited to: Child birth injury, pelvic surgery, lumbar disc surgery, prolonged driving or occupations that require prolonged sitting, gait . 60-80% DID NOT RECEIVE AN ACCURATE DIAGNOSIS (GPWPP 2007) Causes of Pelvic Myofascial Trigger Points Excessive tension on muscle fibers Once other possible causes of CPP have been ruled out, consideration of the myofascial trigger points must be made by a physician trained to do so. We are not familiar with a pelvic floor PT in the metro-Detroit area, however, below are two PTs in Michigan who have taken our course: Miles Kristen PT Royal Oak MI (248) 655-3011 [emailprotected] Womens Urology Center Veeser Catherine PT Ferndale MI (248) 655-3000 [emailprotected] William Beaumont Hospital. Intimate Rose Pelvic Wand with Vibration for Pelvic Muscle Pain Relief - Pelvic Physical Therapy Use for Trigger Point & Tender Point Release - Men & Women. It is not just the complex structure of muscles in the pelvis that can develop trigger points. .Doctors put me on Prozax and gabepentin and has helped the nerve related pain so what. Areas of the body. Clinical Member of the INTERNATIONAL PELVIC PAIN SOCIETY, 2023 Intimate Rose. David Simons and Janet Travell ( Janet Travell now deceased) were both Doctors, not a PT and were never a husband and wife duo. The something-stuck-in anus sensation usually comes when i try to relax my pelvic floor. Your article has helped calm me down, but I am still really scared. I moaned and she took it to mean that it hurt so asked if I was ok. Indeed, in some cases, theyre the only culprits. However, without an evaluation, I am unable to know for certain. These trigger points can be highly sensitive and painful, and when pressed can refer pain to other parts of the body. I have no life at all. Unable to load your collection due to an error, Unable to load your delegates due to an error. However recently I have experienced spasms in my pelvic floor making me feel like I have to urinate frequently. Shes a professional and should be able to handle it as such. Internal work may not have an impact on sciatic symptoms, many things outside of the pelvic floor can contribute to that symptom. Indeed, pretty much everyone will deal with trigger points at some time in their lives. Request PDF | The Effectiveness Of Trigger Point Treatment In Chronic Pelvic Pain; A Pilot Randomised Controlled Trial | Objective To investigate the effectiveness of ischemic compression and low . In Female Pelvic Pain, Male Pelvic Pain by Stephanie PrendergastAugust 20, 2012139 Comments. royal college of orthopaedics I read an article on pelvic muscle floor tension by a woman named Jeannette Tries which helped answer some questions and your article also helped and made some things clear. Just like you said in the article i thought, and so did the doctor, that it was a UTI. However Im sorry to hear youve been struggling with pelvic floor and lower extremity issues. Your Botox answer is also very interesting so I think we have a lot to discuss. For instance, a trigger point in the levator ani muscle can cause a trigger point to occur in the abdomen. . My answer was complicated and did not want to type it all as I am not at all good. Remember, if you are strengthening and the pain is worse, there are MTrPs left untreated. We would be happy to evaluate you in one of our locations or you can use our website to find a pelvic floor physical therapist in your area that can help. Also, ohio state has added a few PTs who specialize in pelvic floor pain. I have a nerve block (ultrasound guided) with pulsed radio frequency set up at Andrews Clinic in Gulf Breeze, Fl on 01/06/15. Enter the email address you signed up with and we'll email you a reset link. For more information and to schedule, please visit our, In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Masters degree in Integrative Health and Nutrition. 8600 Rockville Pike Finally Dr.s are realising that when there is a physical symptom there is a physical cause! Those who do not understand the role of trigger points in chronic pelvic pain may suggest traditional therapies, such as, Kegel exercise, which can worsen symptoms unless trigger points are brought under control. The following muscle groups can contain trigger points that produce pain and cramping in the pelvis and abdomen: The Adductor Magnus. My PT is a wonderful therapist who understands this condition and has specialized in pelvic floor cases exclusively. Without intending to over share, Ive had painfree intercourse for the first time in my life! Do you have any qualified therapists near Bloomington, Indiana? What both the doctor and Jane are missing is that the cause of her urinary symptoms is a patch of constricted muscle fibers in a small, out-of-the-way muscle in Janes pelvic floor. pregnancy PMC Please let me know you thoughts on all of this. We are here for you and ready to help, whether it is in-person or online. Any lifestyle modifications or triggers that can be identified with me would be welcome news. Results: Ive since noticed multiple, extremely painful trigger points in my pelvis area that duplicate and intensify the pain I experience. Fisher's exact test was used to compare palpation responses, ie referral pain, stratified by reported pain site. The cost for this service is $75.00 per 30 minutes. and at least three different antibiotics. When the stretches are coupled with relaxed breathing, it is possible to learn to observe when the muscles have become clenched and to consciously relax to them to avoid a flare-up in pelvic pain. We are just now trying to strengthen. Hi, I live in Odessa, Texas! At its heart,Pelvic Pain Explainedis the story of how patients develop pelvic pain, the challenges patients and providers face throughout the diagnosis and treatment process, the difficult task of sifting through the different available treatment options, and the impact that an invisible condition has on a patients life and relationships, and much more. Epub 2009 Oct 17. The following session she told me she would be very careful not to trigger the spasms again because it left me so sore and she didnt. Do you know anyone that does that for pelvic floor problems in Dalton, Ga? I may never be completely free from periodic symptoms, but I am MUCH better today than I was 13 months ago. Are pelvic muscle floor tension and trigger points related or the same thing? Vaginal Balm My understanding is that the work that is producing that result is the left levator ani (I ask where she is all the time as I like to understand) and that make sense in terms of urethra/penile referral that would need to be addressed. In addition take a look at our blog post about finding a PT in your area; perhaps it will have some tips that will help you in your search. This is a diagnosis that is way over diagnosed by physicians, likely because there is a surgery involved. Hi Liz, Thank you so much for this post. When i left i used ice and also later that evening to calm down a flare. I suggest that you consult with a local pelvic floor therapist for an evaluation. Can you recommend anyone in New Jersey? J Urol. Can you suggest a good PT in Spokane, Washington that is qualified in assisting in these areas can address releasing these trigger points to alleviate this two year old daily pain and discomfort. Your question would be best answered by Dawn Sandlacini, in Denver. Next I had the cortizone nerve block no help. This is so horrible and I am so tired of not performing daily duties as I used to. postpartum tattnall county mugshots; programas de univision 2021 Menu Toggle. Tracy Sher, PT Florida Hospital Altamonte Springs, FL (407)257-1403, Ashely Arango, PT and Katherine Marsh, PT Florida Hospital Pelvic Health Rehab Orlando, FL (407) 303-8280. He is extremely frustrated. Our Internal Trigger Point Wand (the Wand) is the first scientifically designed device for internal myofascial/trigger point release for pelvic pain relief that has been in a clinical trial and whose results have been published by a peer-reviewed journal and presented in scientific meetings. If PT is not a good choice right now cognitive behavior therapies, guided imagery, or pharmaceuticals may be useful. 2007;26(2):66-9. . For example, in women, trigger points in the obturator internus muscle of the pelvic floor can refer pain/irritability to the urethra. There are many mechanisms of injury that can cause spasm of the pelvic floor. It discusses what to expect for treatment. If you have chronic pelvic pain (CPP), you know the symptoms. https://pelvicpainrehab.com/pelvic-pain/726/how-do-i-know-if-i-have-pn-or-pne/. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! You'll get health news, advice, and inspiration delivered right to your inbox. She is busy all the time which goes to show you just how many people need the assistance and cannot find it. Exercise benefits. It just seemed to aggravate everything whenever I had it done, which was about 6 or 7 times last year. Thanks very much. We randomly selected a cohort of 72 men who underwent treatment with physiotherapy and relaxation training from 2005 to 2008. Curr Urol Rep. 2006 Nov;7(6):450-5. doi: 10.1007/s11934-006-0053-6. I would recommend that you see a local pelvic floor therapist in order to determine the exact cause of your symptoms. All Rights Reserved. Take a look at the following blog posts, which explain what we consider to be appropriate PT for pelvic pain: As for your question about whether a weak pelvic floor could be part of your problem, its impossible for me to speculate as without examining you I cant really guess as to what impairment/s are contributing to your symptoms. Experts at Rose Physical Therapy use trigger point dry needling can reduce pain in the muscles of the pelvis and perineum. I feel the spasms are coming from my pelvic floor. Im focusing on TMS ( Tension Myoneural Syndrome) and meditationpretty desperate and despairing, but Im walking around, so it beats a lot of thingsthere is something out there that will help that I have yet to find apparentlyhappy to connect if you want to [emailprotected]. use wand on any sensitive, tight, or spasmatic spots inside vagina myofascial release while using wand on these spots can also help -- basically pull dry skin (requires friction) from vulva to hip bone repeatedly on either side while massaging sensitive spot internally Diagnois is oeistis pubis degenerative disease. Does anyone have any suggestions? You mention that you know of some. I of course Im a guy but I too live in Columbus Ohio and was wondering if you ever found some good hands on pelvic floor physical therapists in the area? Pelvic floor dysfunction can be caused by many things, including inflammation, irritated nerves, restricted blood flow, pushing or straining to urinate, and is aggravated by conditions like Interstitial Cystitis (IC / BPS), prostatitis, vulvodynia, vaginismus, pudendal neuralgia, lichens sclerosis/planus and dyspareunia (painful sex). I am 34 and have been in terrible pain since I was 10. J Man Manip Ther. Check out our website and read the blog posts on this blog for more information. A few months after the LRP, I had some scar tissue form at my bladder neck & had to have a bladder neck incision. The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. 'Internal Pelvic Release' is the most advanced way to release these triggerpoints. Before ~ Anne, Dear Anne.Sorry for delay in replying but ended up with back problem and laptop probs. The pain has truly become intolerable and Ive developed hip, lower back, and ankle issues on the right side of my body as a result. Yoga will do that! We appreciate your comment. Im now 55 and have extreme anal pain (my first time to experience it). Do you think that I am on the right track? I told her about everything except for correcting her assumptions regarding those spams. Begin Pelvic Floor Self Massage using surgical gloves to find tight and sore areas in and around the anus as well as the walls of the vagina and base of the penis. In the physical therapy component of Dr. Anderson and Dr. Wise's treatment program, they map the pelvic floor trigger points and train patients to massage them internally with a j-shaped, rigid wand made of . I have seen her 9 times and feel considerably better. At this point I do have a question and because of the nature of it, have not been comfortable addressing it with my PT. The first five months I was told by urologists (14 visits) that I had prostatitis. Myofascial trigger points in adductor magnus (thigh), or internal oblique (abdomen) are capable of causing bladder pain and frequency. Structures addressed. I dont take anything stronger than Naproxen 500 or a few advil for pain but sometimes the burning is almost unbearable. I always welcome a professionals advice thats well versed in pelvic pain. The Intimate Rose patented pelvic therapy wand and vibrating wand were designed to ergonomically reach both the superficial and deep pelvic floor muscles to release trigger points and tender points in the pelvic floor. Jamie Justice, PT Creative Therapeutics Dekalb IL (815) 785-5508, Kristen Markett, PT Flexeon Rehab Orland Park IL (708) 671-1971. Get your facts straight. Hope ahead. However, while it is possible for trigger points to be the sole cause of pelvic pain, its much more common for them to be just one component in a multi-layered problem. Here is where my issue begins. The unique contours were designed by a pelvic physical therapist to provide comfortable reach for easing pelvic pain. However, our blog does not discuss David Simons or Janet Travell, much less their personal relationships. She seems very knowledgable and I am hopeful, but wonder what happens it this is unsuccessful. I saw that you had pelvic floor injection for a tight pelvic floor (although this post was from 2014). My pelvic PT tells me I have trigger points in my obturator internus but she doesnt do dry needling. Bottom line, the resting tone in my pelvic floor was extremely high in spite of 7 hours of yoga and pilates a week. 2020 Dec;204(6):1275-1283. doi: 10.1097/JU.0000000000001237. In columbus, Mount Carmel east has a great womens health program with pelvic floor PTs. Thanks. Kegel exercises actually hurt now & everything just feels different in that area. Hes the best doctor Ive EVER seen! 2022 Apr;30(2):124-131. doi: 10.1080/10669817.2021.1985693. The site is secure. How to handle? i hit the wall, went blind with pain. The most pain typically occurs after exercise. patient's self-treatment of internal myofascial trigger points in the pelvic oor and its eect in reducing pelvic muscle tenderness. I have had pain in the inner thigh area. But the overall muscle tightening that followed the guarding could also have caused them to develop, not to mention Loris new habit of holding her bladder because of her urgency/frequency issues. Whilst trigger points may be the primary cause of pelvic pain in some patients; in others it may be a response to an underlying pelvic disorder.. Unfortunately she cannot do this work at hosp. Ajimsha MS, Ismail LA, Al-Mudahka N, Majzoub A. Arab J Urol. I am currently being treated with neurontin (for nerve inflammation) and PT. The pain started in my left testicle but I also feel it in my perineum and in my pubic area. To me, it feels sort of like a lentil. 13(1) 2005, Myofascial Pelvic Pain by Rhonda Kotarinos, Myofascial Trigger Points and Myofascial Pain Syndromes: A Critical Review of Recent Literature by David Simons and Jan Domerholt, The Trigger Point Manual by Drs. While you are figuring that out, it makes sense to consult with a pain management physician to help you manage your pain. At hanks you so much for your work in this field and thie info you put out there for all of us suffering and looking for answers. I would also like to refer you to a blog post that we wrote on pelvic pain specifically: https://pelvicpainrehab.com/blog/2012/07/male-pelvic-pain-its-time-to-treat-men-right/. Beth Stidham, PT is located in St. Paul, MN and is a great resource for you. I never seem to get any relief from the second physios internal work so I am a bit lost as to whether physio is my answer. He or she will be able to explain why consistency is so important, and will help calm any fears you may have. P.s. Trigger point injections: These are administered by physicians and typically contain anesthetic; however, its the actual injection that will successfully release the trigger point, not the anesthetic. Myofascial pelvic pain described as myalgia condition with local and referred pain patterns, it refers to pain found in the pelvic floor musculature and the connecting fascia. Can you give me more specific information? The same applies to physical therapists or therapeutic massage therapists/body workers. I am sorry to hear about your daughters situation. Lastly, here is a blog post that gives advice on finding qualified PTs that might help you: I have been suffering from chronic pelvic pain since the summer of 2013. Young men can experience urinary urgency/frequency, discomfort after ejaculating, etc. The episode you described as a backwards orgasm is likely due to her inadvertently massaging your prostate. Whatever the reason for their development, trigger points are famous for complicating already painful situations, and in many instances, they stick around long after the original problem clears up. Recently the surgeon said I should go back to see her, but not convenient to go every week and I was speaking to him about having botox, but now he has said I would get faecal incontinence for 3 to 4 months have you heard of this and what would you recommend please. (I didnt go thank goodness, sensing that was the wrong path). Pain sensation at each anatomical site was reproduced by palpating at least 2 of 10 designated trigger points. can you recommend a pelvic PT in the Boston, MA area? Do you have any particular therapist in the metro-Detroit area that you would recommend? Anyway YES Carolyn is the person I saw.Doc at Mater Dei recommended I see her, spoke to her briefly at hosp, and saw her at ST Annes.

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