Joan,

When they direct you toward the room used for the pelvic exam, I would politely say, "Thank you, but my physician's orders are for PN and leg strengthening, so let's stay stay focused on this please". You can follow up (if you feel the need to) with, "I'm current able to do the Kegel exercises at home". This way you are NOT looking "uncooperative".

Just got back from the regular PT session and told them I'm not doing any of it any more because I'm not seeing any improvement.

See, I was playing the game because once before, I went to a "pain management" doc, and she wanted to sign me up for this group PT/OT/talkie scam (their own in-house) and you had to sign your life away to them and it looked to me like you were signing away any hope of them backing up any disability claim ever and all sorts of other legal pitfalls. And it wouldn't have even been a group of other PNers! So I said "no" and the doc said "well, then I'm not going to prescribe anything for you" when all I wanted was Amytripteline.

So you see, after that, I'm afraid of docs withholding treatment if I don't at least pretend to go along with their other stupid ideas. But this was just going too far. Ya gotta draw the line somewhere. Besides, I got laid off again two weeks ago, and even with the good insurance, the decutible is killing me.

Oh, and thanks, en bloc, but the doc kind of knew about this and appeared to approve of it, so I couldn't really do that. But otherwise it would have been a good idea.

It is all about money. Some health professionals will often say that you need another exam or test and this could go on forever unless you decline.

--that specialize in pelvic release/manipulation/therapy, but this doesn't sound like one of them.

Such practices are extremely specific in their treatment modalities, and yes, they may well involve a lot of manipulation/tissue release in the perineal area, but they don't do repeated "pelvic exams". Generally, they work on restoring function of the pudendal nerves that stem from the S2/S3/S4 nerve roots--often there are problems of compression along the length of that nerve, or a sacrum malpositioning that causes problems with compression of the nerve roots. (This is very hard to diagnose; most doctors simply don't think of sacral problems as being part of the possibility for neurological symptoms in that area--they seem to stop at the S1 level.)

Yes, I know a lot about this--I've had problems with those nerves and have to do intermittent physical therapy for the situation. My symptoms are sensory and so far have not involved autonomic processes, but they do involve the peroneal and genital area. (This constellation of symptoms tends to be more common in women, but men do get it too--especially those of us with bad posture who sit a lot.)

Take a look at:

http://www.pudendal.com/

http://pudendalhope.org/

I think that what you're referring to is probably what this was, glenntaj. So I wasn't accurate in calling it an "exam"...but in my experience, that was the closest thing that I could relate it to. She kept pressing on different areas and asking if it was painful, so that seemed like an exam to me. You have educated me, and thanks.

But I didn't come in there with those complaints, so I still maintain that they were looking for ways to pad the bill.

Anyway, I guess a lot of us learned something through this and that's a good thing. Kind of an expensive lesson for me, but I've had to learn much costlier ones in my life, and not always in terms of money.