First off, my post is all dependent on you having CPPS. I don't know if you do or not. I'm not a doctor. My advice is speculative, at best. And what I say may or may not even apply to you. But still, I'm glad you posted. It
sounds like you are at the right place. And you sound like you have your head around this the right away. I've always viewed the SP as a no-brainer therapy, whether or not you are sure you have CPPS. There are so many parts of the SP that you can do for free, on your own
while evaluating other options and causes for your pain. It just makes no sense to hold off on starting the SP when 90% of the pevlic myoneuropathy cases benefit from the SP. A big mistake many people make is to hold off starting the SP for the 6-12 months they take going through urological evaluations. If, as in most cases, the urological evaluations come back negative for more serious problems, the patient's condition has only worsened over the year, and their psychological state has gone down the toilet with it. Why not cover all bases and just do the SP while at the same time getting more diagnostic tests done (if that's what you want)? It makes sense to me. But I'm a biased SP-success-story so far, so my opinions are worth only 1.5 cents anyway.
Here are some more specific answers to your questions:
Also I am attempting to self-treat as much as possible for financial and personal reasons.
ANY treatment is better than no treatment. Technically, everything about the SP can be done by you (relaxation, massage, external therapy, internal therapy with a caveat). My caveat on internal work is that you should at least spring for 1-5 sessions with a professional so you learn what things need to feel like. Confidence in what you are doing internally is SO important, especially when the post-treatment flare-ups start. If you are not confident, you'll back off. Unless you REALLY stay with it, and REALLY trust yourself. And that's hard to do when the pain is bad and your emotional state hits the roadside. You can talk yourself out of
anything during those times, even things that you know are good for you. But (my exception to my caveat), if you can't afford ANY treatment from a PT at all, don't hesitate to treat yourself. Your quality of life depends on it. But if this is the case, you need to do things differently. I would recommend working slowly, and building up your therapy step by step (this is good advice for any of the therapy you do, not just internal work). For example, start by working around the anus, and the muscles there. Then work
just inside the anus (the area just inside the opening). This area is one of the most active for trigger points, and one that benefits pretty quickly from therapy, and is also one of the less "dangerous" spots to work on (although all spots can be dangerous if done incorrectly), as well as one of the most accessible. I'd work on this area for a while, until you are comfortable with it and get a sense for the flare-ups that occur on it. Once you've gained some experience, you can work a little deeper. HOWEVER, working around your prostate will be difficult
AND can be dangerous, no matter how much experience you have. If you have a girlfriend or spouse, getting them to help do any of this therapy is a big help. Significant others can make a big difference in therapy, and can be a PT resource for the rest of your life. They can save you tons of money, and therefore investing in a few PT training sessions with a professional and your significant other is well worth the investment.
1) Where should I begin with the SP? Are there trigger points I can hit to help with the shy bladder more quickly? Are the relaxation tapes available without going to a seminar?
I would jump heavily into all stretching exercises, relaxation exercises, and external trigger point work immediately. One mistake people make is tiptoeing into the SP. This doesn't work, and people never see the full benefit of it, and just give up when the first few flare-ups occur. Do it all. Do it long. Do it hard. Don't give up. And be tough. Grit it out, and you'll see improvement
eventually. I say "eventually" because the norm for improvement is anywhere from weeks to years. But if you are a good candidate for the SP, you'll see improvement at some point. How soon depends on where your trigger points are, how many there are, how tough they are, how you treat them, and lastly, how your body heals. There are no guarantees on any of this stuff.
For stretching, read up a lot on what you see here. For many of us, abdominal stretches (cobras and the like), squat stretches, groin stretches, and hamstrings and lower back stretches are key. Note that in my case, stretching did little until I started to break down my trigger points with therapy. After that point, the stretching made a huge difference. It improves muscle tone and blood flow, giving your tissue vital food to heal and prevent oxygen starved tissue from reforming trigger points. But once a trigger point is dead-set on sticking around, you have to forcibly remove it via therapy.
For external work, buy a Theracane. Now. Today. It is a life saver. Don't discount external trigger points. I was amazed at how important my abdominal TP's were for my testicular pain (my worst symptom) and minor penile burning. This cannot be understated. Also of key importance for many of us are the muscles in the perineum. These were a source of almost all my ejaculatory pain, and a few months with the Theracane has all but eliminated that symptom. For Theracane work, don't be shy. go easy at first, learn your body, and then pour it on. You have to dig in those muscles to get the TP's out. And it will hurt at first (you'll have a bruising sensation on the tightest muscles). But, eventually, you'll work spots that don't hurt any more at all. Note that there are many abdominal nerves that will always hurt when you press on them, but this doesn't mean that TP's are always there or coming back. But the pain will lessen as you improve. The basic rule is: if it hurts worse than comparable spots near it or on the other side, work it out with the Theracane. If it causes flare-up pain, work it out harder. Once you get going with the therapy, don't back off. You'll just be giving in to the pain. And don't make your "good" flare-ups for naught. You
have to go through it. Just get it over with as quick as possible, as many weeks or months as that may be. (never evaulate your progress during the first 6-12 months - it's just not worth it).
For relaxation (you asked about it above), there are tons of tapes on relaxation, from cognitive relaxation, to progressive muscle relaxation, to anxiety reduction. Do a search on the forum for best tapes, and you'll find a lot out there. Without Dr. Wise's tapes, you'll just have to do the best you can. But basically, you need to relax those pelvic muscles and keep them relaxed. For me and many others, the moment to moment relaxation during the day is key (always being aware of your tension level and causing it to back off as often as you can - notes on the desk help).
For internal work, you can pretty much read my first response at the top.
And that's the SP in a nutshell. Just get started, and if it turns out you never needed it, well, that will be $0 you just wasted.
2) Has anyone looked at their own prostate fluid under a microscope? What do the leukocytes look like? I have a scope but not sure what to look for exactly - what stain to use etc. I did use a urine test reagent strip on EPS and it blew up on the leukocyte test area.
Don't know this one.
3) I don't want a useless course of ABX (or a useless string of expensive specialist visits ) but I feel like I need to totally and finally rule out bacteria, yeast, etc. so I can "believe in" and focus on the SP and muscle tension as the ONLY culprit. To this end has anyone cultured their own EPS for bacteria and/or yeast and if so how? I have access to lab supplies.
Yes, you
MUST believe in the SP to be successful. This is because it is slow, causes flare-ups, and isn't a quick fix. Without some believe and confidence, it is very hard to push through the hard stuff for a year. That's why you have to fight for even the smallest improvement, and recognize it when it comes, through all the tough emotional baggage you are carrying due to the pain. Still, I think you have to start the SP before you fully believe in it. Why wait until you can convince yourself of it's success? In the short term, trust us, and use the forum, and hopefully you'll get through the beginning. After you get your first flares, you can have more confidence that you are hitting the right notes.
4) How does alcohol aggravate the prostate? If I overindulge I feel like my prostate is overfilled the next day or 2 and I can express a large amound of cloudy fluid. This is why I suspect yeast involvement. I also get a vague but noticeable "itchy" feeling prior to ejaculation a day or 2 after heavy drinking. Also is "normal" EPS clear as ANF states?
I don't know the answer to this. I'll let others respond. I
do know that alcohol exacerbates my IBS, which affects my abdominals, which are related to my pelvic pain. So I know it's not all independent. But as to your more specific issues regarding yeast and itching, I can't really say.
THANKS!!! in advance for any help or advice. I feel like the SP will be the way to go but I need to clear my mind of "what-ifs"so I can give it 110%.
No problem. Use this board for support. You're not alone. All your answers are here if you look hard enough. We all hate this problem, but we have to stick together. Do the SP, while at the same time as you eliminate all the "what-ifs". Cover your bases. And check in here often for support when things get rough, letting us know how the treatment is going.
Mike
(did you buy your Theracane yet?)
This is NOT medical advice. I am NOT a doctor.
Age: 43 CPPS: 10+ Yrs Recovery Status: 80-85% Symptoms: Pain in testicles, scrotum, rectum, prostate, perineum Makes Worse: Anxiety, Tension, too much Nookie Makes Better: Stretching, Abdominal Massage (Go Theracane!), Relaxation
) but I feel like I need to totally and finally rule out bacteria, yeast, etc. so I can "believe in" and focus on the SP and muscle tension as the ONLY culprit. To this end has anyone cultured their own EPS for bacteria and/or yeast and if so how? I have access to lab supplies.
