MECHANICALLY INDUCED PELVIC PAIN AND ORGANIC DYSFUNCTION
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MECHANICALLY INDUCED PELVIC PAIN AND ORGANIC DYSFUNCTION: THE PPOD SYNDROMEFREQUENTLY ASKED QUESTIONS
Q.
How is it that Doctor Browning, a chiropractor, can help me?
I’ve been to so many different types of physicians and specialists,
and have undergone every conceivable test and type of treatment, if they
couldn’t help me how can he? A.
Although the mechanically induced PPOD Syndrome is caused by an
“atypical” mechanical disorder of the spine, it manifests itself by
producing a wide range of symptoms of bladder, bowel, gynecologic, and sexual
dysfunction. Because these
symptoms cross the boundaries of several different medical specialties, PPOD
patients have typically consulted several different types of specialists in an
attempt to identify the cause of their complaints.
Given however, that the underlying disorder is of spinal origin, most
attempts at treatment (medical or surgical treatment directed at suppressing
or resolving the symptom rather than it’s cause) usually have little lasting
effect. This fact is clearly illustrated in the histories of the accompanying
case reports. Fortunately however, despite the lack of response to symptomatic
medical treatment, once the underlying cause of the disorder has been
accurately identified and appropriately treated, all PPOD related symptoms can
begin to resolve. Q.
If the mechanically induced PPOD Syndrome is caused by a spinal
disorder, why hadn’t any of the many medical specialists I have already seen
identified it? A.
In short, because this disorder falls outside of their area of
expertise. While the PPOD
Syndrome typically causes symptoms of a urologic, gynecologic, enterologic and
sexual nature, these disturbances very often mimic other conditions associated
with internal disorders of the pelvic organs.
As a result, doctors who specialize in these areas of internal
medicine, and, who typically have little training in dealing with mechanical
disorders of the spine, commonly diagnose these complaints as being due to
some type of local internal pelvic organ dysfunction or pathology. Having been
so diagnosed, treatment typically proceeds along lines that further diverts
attention from the true nature of the problem.
Furthermore, the “atypical” presentation of this condition so
commonly encountered, tends to further complicate the picture by making
identification of its true origin difficult even for those who are
trained in the diagnosis and treatment of the typical types of mechanical
disorders of the spine. Q.
Can I still be helped if I have undergone surgery for my problem(s)? A.
Yes. As is apparent from
years of clinical experience, as well as, the accompanying case reports, many
PPOD patients have undergone prior (sometimes numerous and different types of
surgeries in an attempt to resolve their complaints.
While often times these surgeries have provided no, partial, or only
short term improvement in the disorder (or symptom) for which they had been
performed, these surgeries generally have no significant effect at
compromising the potential for recovery when treated properly. Q.
I have undergone all kinds of diagnostic testing (laparoscopies,
sonograms, CT scans, MRI, cystoscopy, colonoscopy, etc.), and everything is
“normal”. I’ve been told
that “there is nothing wrong”. If
this is the case, why do I feel the way I do, and, if “nothing is wrong”,
what can you do to help me? A.
This scenario, of having undergone numerous diagnostic studies in a
vain attempt at trying to identify the cause of PPOD related complaints is a
feature common to many PPOD patients. This
seems to be due to the fact that the diagnostic procedures used in the
evaluation of patients with PPOD related complaints are designed to reveal
pathological anatomy (abnormal changes in tissue structure) of the various
organs assessed. While these
procedures can detect structural abnormalities, they are incapable of
identifying the presence of abnormal function. Most PPOD symptoms however, are the result of functional
disturbances (abnormal functioning) of the pelvic organs, induced by a
mechanical disorder of the spine. As
a result, despite the fact that the pelvic structures may appear “normal”
from a structural standpoint, pelvic organ dysfunction typically remains
undetected. So, while there may
be “nothing wrong” from a diagnostic (structural) standpoint, significant
organic dysfunction can persist.
Once the underlying disorder has been properly identified and
appropriately treated however, all associated symptoms typically begin to
resolve. Q.
Can my chiropractor treat me? A. The mechanically induced PPOD Syndrome is a newly recognized disorder. As a result, most chiropractors are not yet familiar with the diagnostic and therapeutic protocols necessary to identify and successfully treat this condition. In addition, treatment success is highly dependent upon the skilled application of specific procedures (not utilized or practiced by all chiropractors) in accordance with therapeutic protocols that have been developed and refined for maximum effectiveness when properly matched to the variant forms of this disorder. Treated in the wrong way, symptoms may be aggravated, and the PPOD Syndrome may worsen. If your chiropractor has been following this work through published research, and, has treated sufficient numbers of PPOD patients to consistently get good results, then he or she may possess the background and experience necessary to effectively treat this disorder. As there are not yet any programs in existence to train clinicians in the recognition, diagnosis and management of the mechanically induced PPOD Syndrome, there is no repository of names to identify individuals who are qualified in caring for this disorder. The only way to locate a doctor who may be experienced in treating this disorder is to call their office and inquire specifically about their knowledge of, and experience in, treating the mechanically induced PPOD (pelvic pain and organic dysfunction) Syndrome. If they aren’t familiar with the term (“PPOD Syndrome”), they probably are unaware of what it is and the proper treatment protocols utilized in its care.
Q. Is there a doctor in my area that help me? A. We do not have a registry of other doctors who may be familiar with the PPOD Syndrome. Your best bet is to call the offices of local chiropractic doctors and ask specifically if they are familiar with, and, experienced in treating the PPOD Syndrome. Please do not contact our office for assistance in this regard as we simply do not have this resource to provide.
Q.
I’m already seeing a chiropractor, and, either, a) haven’t noticed
any change in my condition, or, b) my condition has gotten worse despite
treatment? A.
As mentioned above, the success in treating the mechanically induced
PPOD Syndrome is dependent upon two factors; 1) the identification of those
individuals who are in fact
suffering the effects of this disorder, and, 2) the proper administration of
appropriate therapeutic procedures following specific treatment protocols. If your condition is
due to the mechanically induced PPOD Syndrome, but the treatment you have been
receiving is inconsistent with the protocols necessary to effectively deal
with this disorder (wrong type of treatment, and/or inappropriate
therapeutic/management protocol), a positive therapeutic response would not
be expected to occur. Success in
treatment depends upon accurately identifying those individuals who do in fact
suffer the effects of the mechanically induced PPOD Syndrome (which can only
be determined by the results of specific examination procedures performed and
interpreted by a clinician experienced in treating this disorder), and,
the skilled delivery of treatment following the appropriate therapeutic
protocol for the variant form of this disorder. Fortunately however, most PPOD patients who have failed to
improve while under prior “conventional” chiropractic treatment have
demonstrated an excellent response once treatment and therapeutic protocols
have been modified to appropriately treat the mechanically induced PPOD
Syndrome. Q. Must I come to
Suttons Bay for treatment? Can’t
you tell my chiropractor how to treat me? A.
Because of the complexity involved in assessing individual clinical
needs, prescribing appropriate treatment and monitoring therapeutic response
from a distance, we have refrained from trying to teach PPOD diagnostic and
therapeutic protocols to inexperienced (relative to PPOD) practitioners over
the phone. However, because of the many requests we have had to provide
a means by which PPOD patients could receive treatment by a chiropractor in
their hometown, we will provide generalized therapeutic recommendations to
confirmed PPOD patient shaving been examined by Dr. Browning in Suttons Bay
(see SERVICES PROVIDED). These recommendations can be used to guide
their hometown Doctor through appropriate PPOD protocols. It should be
realized however, that although this arrangement provides another option for
PPOD patients, there is the potential for compromise in therapeutic outcome
due to inexperience by the treating doctor, as the initial few weeks of
treatment represents the critical period during which the development of
complications requiring a prompt and precise therapeutic response or
modification in treatment protocol are more likely to occur. In the
hands of an inexperienced practitioner, there is a possibility that things may
go wrong. A situation analogous to a heart patient being treated by a
general practitioner as opposed to an experienced cardiologist.
Individuals however, who wished to take advantage of his many years of
experience in treating the mechanically induced PPOD Syndrome, may stay in
Suttons Bay and be treated by Dr. Browning during a four-week treatment
rotation. Q.
Will I be cured? A.
While in most cases a complete or significant
resolution of symptoms can be achieved, most PPOD patients are not “cured”
in the sense that there will be no tendency or likelihood that their symptoms
may recur. The reason for this is
that the type of disorder underlying the production of the mechanically
induced PPOD Syndrome is by its very nature, somewhat unstable.
In addition, some individuals have accompanying conditions or
“factors” that can contribute to altering the stability of the condition.
As a result, although in most cases an excellent response can be
anticipated, it may be necessary to receive periodic treatment (which should
be able to be obtained close to home) to maintain stability and sustain your
improved clinical state. Q.
Will my insurance company cover treatment?
A.
This is difficult to say as insurance coverage varies greatly from
company to company, and policy to policy. Based on past experience, however,
reimbursement for treating the mechanically induced PPOD Syndrome has ranged
from none to significant. In some
cases, plans that typically provide for chiropractic coverage however, may
limit or deny reimbursement for various reasons. Because of the difficulties
and uncertainty in dealing with the many different insurance companies and
their policies, we generally do not accept
insurance assignment when treating or consulting on the mechanically induced
PPOD patient. All charges for all
services are to be paid in full by cash, check, Visa or MasterCard.
We will provide you with the information necessary to file your own
claim. It is your responsibility
however, to file your claims, and follow-up on obtaining any reimbursement
from your insurance company.
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