How Underdogs in Pelvic Health Can Advocate For Ourselves with Michelle Lyons

Where to find Michelle Lyons:

• IG: michellelyons_muliebrity
• www.CelebrateMuliebrity.com
  
  
• Get Lindsey's 9 page OTs Map to the World of Pelvic Health.
• Meet Lindsey on the OTs for Pelvic Health Facebook Group!
• Check Out More OT Pelvic Health Content here.
• Find Lindsey on IG! @functionalpelvis

Books that Michelle mention in the this epsiode:

• The Body Keeps the Score
• Why Did No One Tell Me?
• Beating Endo
• The IC Solution

____________________________________________________________________________________________
Pelvic OTPs United - Lindsey's off-line interactive community for $39 a month!
Inside Pelvic OTPs United you'll find:​

• Weekly group mentoring calls with Lindsey. She's doing this exclusively inside this community. These aren't your boring old Zoom calls where she is a talking head. We interact, we coach, we learn from each other.
  ​
• Highly curated forums. The worst is when you post a question on FB just to have it drowned out with 10 other questions that follow it. So, she's got dedicated forums on different populations, different diagnosis, different topics (including business). Hop it, post your specific question, and get the expert advice you need.

More info here. Lindsey would love support you in this quiet corner off social media!

Transcript

Copy Transcript Copied

 Lindsey: (00:00)
Today on the OTs in pelvic health podcast, I have a special guest, the one and only Michelle Lyons. Now Michelle is the first PT guest I've had on my podcast. And I am honored. Now. She qualified as a physio in 1994 and started her career in sports medicine until her obstetric MIS adventures inspired a career trajectory change to women's health. Her toolbox includes teacher trainings in yoga and Pilates, mindfulness as a therapeutic intervention and a postgrad in health coaching and nutrition. I cannot wait for you to hear the topics we dive into today, starting with her views on how OTs can step up to the plate even more and represent ourselves in pelvic health. New and seasoned OTs are finding their calling in pelvic health after all what's more ADL than sex, peeing and poop, but here's the question. What does it take to become a successful fulfilled and thriving OT in pelvic health? How do you go from beginner to seasons and everything in between? Those are the questions and this podcast will give you the answers. We are inspired OTs. We are out of the box OTs. We are pelvic health OTs. I'm your host Lindsey Vestal, and welcome to the OTs and pelvic health podcast.

Lindsey: (01:34)
Michelle, I am incredibly thrilled and I'm honored that you're here on the OTs in pelvic health podcast. And oh please. I, I, you know, we, you are someone that is, uh, someone I have respected for so long. Oh. Uh, in so many ways, I, I think you are such an advocate for so many issues beyond pelvic health. You know, women's health as a whole, which we really need right now. Um, you, I, I've heard you talk about heart health, menopause, menstrual health. I mean, you, you really are considering the whole person. Uh, and I want to talk, I wanna kick this podcast off kind of with the gr hit the ground running mm-hmm  because in many ways, OTs feel like an underdog in the pelvic community, and you're such an advocate. And so empowering on all of the topics that you speak about, uh, encouraging women to ask better questions, demand better care, and even advocacy around our role as pelvic floor therapists. So since this was a podcast for OTs, I was wondering Michelle, if you had any thoughts to share with us about how perhaps we could continue to find confidence and advocate for ourselves in this field.

Michelle Lyons: (02:53)
Absolutely. Well, first of all, thank you for those kind words and, uh, right back at you, first of all, um, thank you for all you're doing to, to spread the word about pelvic health. And I, I do think it's really important to, to remember and to remind everybody that, you know, women's health is more than just pelvic health mm-hmm , but it is a really central aspect of women's health. Because I think if you're, you know, if you're worried about leaking or pain or prolapse or any of the issues that we associate with pelvic health, it can be so limiting in so many functional aspects of our lives. So for me, it is it's front and center. When it comes to, to women's health, in terms of inclusivity, it is something that I'm also quite passionate about as well, because I think for many OTs working in pelvic health, they are probably where pelvic PTs were maybe 15 years ago in terms of awareness of role and scope and, and even acceptance by the medical community.

Michelle Lyons: (03:55)
Um, I remember, you know, um, , hopefully this isn't TMI, but I remember going to my own gynecologist, uh, when I lived in the us and saying, you know, it was before I had really taken a full, deep dive into women's health, that this is what I was interested in. And, you know, did he, did he know anything about pelvic health rehab issues and very much got the Ugh, you know, please don't, you know, the there's nothing that can be done except for surgery, for prolapse and surgery, for incontinence and medication for pain. And it's, it's kind of hard to argue with the speculum in situ, but I never kind of forgot that. And it always kind of, you know, galvanized me to, to really kind of, you know, hang on a minute, not only is there a huge need for pelvic rehab, but I think looking at it through today's lens, it's really, really important that we very much embrace this bio psychosocial framework that I think OTs really lead in.

Michelle Lyons: (04:56)
And I think we have to remember that the, the psychosocial aspects of pelvic health are just as important as the bio part. Um, you know, if we, we've got some interesting research, looking at the emotional burden of pelvic health issues, particularly prolapse, I was just reading a paper about it this morning. We know that it's a huge barrier to exercise. I, I recently just posted on my Instagram that, you know, we have studies from 20 years ago. I think it was brown at all in 2001, showing that for one in two women, continents issues are a barrier to exercise. And 20 years later, 20 21, 1 in two women, continent issues are still a barrier to exercise. So we need to really look at the whole person and also at their lives, you know, what's, what's their story? What are they bringing to the table? And how is this affecting their ability to live fully?

Michelle Lyons: (05:56)
How is it affecting functional everyday activities? How's it affecting their, their joy and their ability to, to fully express themselves. And I think there's huge potential for OTs and PTs to come together to really maximize the, the therapeutic aspect of both our professions, um, you know, to really enjoy the fullest expression of a biopsychosocial approach to pelvic health. So, you know, I know OTs are, are really well trained in, in issues around toileting, um, particularly, and just maybe, you know, that problem solving capability that I think OTs are deeply trained in is really, really relevant. But I would also say, um, LA no, the year before last I went back and I did a post grad in health coaching and, uh, nutrition. And it was a really eye opening, personal as well as professional development for me, the, the whole concept of health coaching, because I think as a PT, as a physio, we're used to looking at ourselves almost like mechanics coming in to fix you, um, and very much the expert in the room and telling somebody how to, you know, what to do to help themselves.

Michelle Lyons: (07:15)
And I think kind of the health coaching, and I would say I would include OT in this umbrella as well is much more of a facilitator and working with the person rather than, you know, this kind of, you know, um, uh, power differential almost. I am the expert and you are the patient. And I think we could learn as P as physios. You know, we could learn a lot from that. Like, you know, tell me what you think is causing the problem. Tell me, you know, let's work together to come up with an approach. Is this going to work for your life? And I think that's where OTs have a particular strength, as well as the, the skill that I think many of the OTs that I've come across, both in pelvic health and, and in other spheres, um, the use of tools like motivational interviewing and understanding the, you know, the, the stages of change, uh, framework to really look at the, at a psychologically informed approach to helping people live their best life. So I would say to OTs, don't be shy. Uh, please step up. We need you, there's, there's so much more demand than there is supply for services in pelvic health. Um, there are so many people out there who need pelvic rehab. There's more than enough for everybody. And I think OTs just need to get a little bit more vocal about the, the skills that they have from a psychosocial perspective, um, that that's really going to augment the care that we can give patients.

Lindsey: (08:52)
My heart is singing.

Michelle Lyons: (08:53)
yay.

Lindsey: (08:58)
You can't see me because we're on audio. And, and most of our listeners joining us that were audio. And my, I think the back of my neck is in a little bit of pain here because I just, I started off with a gentle, a gentle nod. I'm listening, I'm listening by the end. I'm going rapid fire, like, like a hummingbird .

Michelle Lyons: (09:16)
Yeah,

Lindsey: (09:16)
That was, that was so beautiful. And it, you know, it was, it's kind of a, a PSA, I think, for, for practitioners as a whole to recognize that there's, there's more to the human being in front of us than just one aspect that could be just the bio. That could be just the psychosocial it's, it's an entire person. Right.

Michelle Lyons: (09:36)
I see. Yeah, it, it is. And, you know, I really like the metaphor. I'm not sure I, who I can give credit to on social media for this metaphor, but I just think it's, it's perfect because, you know, when you look at a person as a cake, you can't see which parts are the eggs or the sugar or the flour. You know, we, we, we see PE people come to us as cake and there're all these different aspects of their lives. You know, um, we know that one in three women, one in four women, maybe, you know, depending on which paper you're looking at will have experienced some sort of sexual trauma, you know, so the importance of having that trauma informed approach, mm-hmm , we know that one in three women it's estimated will have some sort of pelvic floor dysfunction, and absolutely it is vital for OTs working in pelvic health that maybe that's an area that they need to upscale in maybe spinal, um, assessment and treatment, hip, or lower limb assessment and treatment.

Michelle Lyons: (10:35)
But front and center, for me, foremost, is care of the person who's in front of you and listening to their story and being able to tease out what are the relevant drivers for the problem that they have in front and, and then working with them, you know, to, to problem solve, um, instead of, you know, just getting hyper focused on, on issues like, you know, trigger points, which we're not supposed to call trigger points anymore. With the new framework for terminology, we talk about tender points, but it's very easy to get micro focused mm-hmm . And instead, I really think we need to be able to take a step back and look at the macro, look at the whole person and their story

Lindsey: (11:16)
That's right. NOTs can up level, they can, they can take those courses, or if they prefer not to, they can simply refer out. Yes. But I, I talk so much about the power of being able to connect with the people in your community to be able, you know, to not take on that. You have to be responsible for the person in front of you 100%, first of all, there's the role of their, of their ability to commit to this experience, right? Mm-hmm , and there's the fact that our own skills may not always be a match. So, you know, I had my private practice in New York city for 12 years, and I, I got to know all of the brilliant P PTs and subsequent OTs that started practices and would refer out when, when necessary or to the nutritionist or to the life coach, or do you name it? And so it's this village mentality that I think really serves our clients, which is the most important thing at the end of the day.

Michelle Lyons: (12:06)
That's it? I mean, you know, I think particularly for people with complex histories, you know, and, and I would say definitely in the, the world of persistent pain, sometimes a pair of fresh eyes, or just, you know, a little bit of outside the box thinking or a different perspective can be absolutely, you know, worth its weight and gold mm-hmm  because you don't have to have all the answers for all the people. It's really, really important. I think that sometimes because pelvic therapists are, are still not plentiful enough, there can be this feeling that we, we bring to the table ourselves, that we have to know everything all the time about all the things. And I think to be able to set up a collaborative relationship is super important, not only in terms of good patient care, but I think also in terms of good self care for us as, as healthcare providers, you know, we do have a high rate of burnout in our profession as pelvic therapy providers.

Michelle Lyons: (13:06)
Um, because it is, it is an emotionally intense job, you know, so to be able to be able to refer out or to ask for advice, and that's where I think like professional networks are so important, whether that's a Facebook group for pelvic health professionals or, or just even within your community, you know, to be able to, to do something like an informal grand rounds where you can present a case and maybe get some different perspectives. I think that's absolutely fantastic. And it really shows our confidence as pelvic health providers that we can say, look, I'm stumped with this. What do you think? You know, do you have any ideas because it's, it's to not be afraid to admit when you are stumped because we're, we've all been there and it's all in the interest of better patient care to, to reach out and a team approach, a multidisciplinary approach time. And again, has been shown to be the most beneficial for all patients, not just in pelvic health.

Lindsey: (14:01)
Yeah. Yeah. I, I love this idea of informal grand rounds. Michelle, are there any other ideas that you have regarding how as pelvic floor therapists we can identify burnout or, or think a little bit more about steps to take, to help the self, this take self cares to prevent burnout or potentially notice that we're going through it?

Michelle Lyons: (14:24)
Um, you know, I, I just think the whole concept of self care needs a little bit of a rebrand. Mm-hmm,  just not, you know, it's, it's, it's really, it's, it's not about the bubble backs, you know, um, it is making sure that you're putting energy back into the system. It's about having clear boundaries. It's about making sure that you have joy in your life as well. And, and being able to leave the, the job behind at the end of the day. And I think that's something that we are not good at from the perspective of our commitment to delivering excellence, when it comes to pelvic health, you know, we're the ones who are going to be doing, you know, literature searches, looking for the research article to help that particular patient, um, and writing the letters and helping them advocate for themselves. But we have to remember that, you know, you, you can't pour from an empty teapot, you know, you've got to refill your own energy reserves as well.

Michelle Lyons: (15:19)
So it's really important that we do look at that, um, that what are we doing to refill our energy reserves? And that's going to make us better therapists. It's going to be sure that we're, we're modeling good behavior, not only for our patients, but also for the other people in our life, particularly the small people that we may be living with that we're able to show them what a healthy work life balance looks like. And I really think that we're not afraid to, to ask for help when we need it. You know, um, there's, there's been, I think, a real decline in the shame and stigma around going to see a therapist or a counselor personally, over the past couple of years. But I wonder like as pelvic health therapist, what are we doing to rejuvenate ourselves? Are we going for, for some body work?

Michelle Lyons: (16:11)
Are we going to a yoga class or something like that where it's, it's one of my most favorite things to do, because you know, I've done the teacher trainings in yoga and Pilates. I know what to do. Like if I wanted to, when I have, you know, the  the focus to have a sustained, you know, regular yoga and Pilates class, I know what to do, but there's something absolutely blissful for me and going to somebody else's yoga class and having them tell me what to do.  so I don't have to think, you know, I can just really focus on being in my body and breathing and, and just kind of paying attention to my own self, because so much of what we do is caring for people on a very deep level, like, how are we taking care of ourselves? Um, so I'd very much look at burnout from that preventative perspective. Um, hopefully rather than a reactive one.

Lindsey: (17:06)
Yeah. That's beautiful. That's beautiful. Now, a moment ago, you talked about the bio psychosocial approach, which I know we're both big fans on. And part of that to me is building in and feeling confident, educating our clients. Yes. The importance of it, along with manual work, along with all of the other tools that we have individually developed, would you mind talking with us a little bit about yeah. How you feel about the importance of the education piece for our pelvic health clients?

Michelle Lyons: (17:35)
Absolutely. Um, you know, if they're open to it, I'm very fond of re recommending books. Like, uh, besel vanco book, the body keeps the score. Um, I think it's an excellent overview of how we, we can carry that tension in our bodies. You know, it's, it's about choosing the right avenue, I suppose, of explaining these things to the people that we're working with. Um, we know that the pelvic floor is a really psychologically sensitive part of our body, you know? So I talk a lot about, uh, the Vanderbilt study from 2001. So it is an older study, but it's still so relevant in that when we are exposed to threat or the possibility of threat before we blink, before we move away, the pelvic floor muscles will tighten up. And, you know, that was done in a study where women were in a movie theater and watching a sexually threatening movie.

Michelle Lyons: (18:31)
So the women themselves weren't even in danger mm-hmm , but their bodies didn't know that. And they still responded their pelvic floors and their upper traps responded as if they were in danger. So I think we have to be aware of the tension that we carry in our bodies. And, you know, we see that particularly in the realm of bowel health, you know, IBS has a huge psychosocial component, um, so much so that there's a better evidence based for things like yoga, uh, than pharmaceuticals for treating IBS. Uh, we talk about the gut brain access and, and polyvagal theory. We can't separate the mind from the body. So it depends on, on someone's approach and outlook, you know, I'm, I'm a big fan of using questionnaires to screen for these issues. Mm-hmm,  so things like the central sensitization, uh, inventory, the, the da, um, really look at self-efficacy questionnaires, the Tampa kinesia phobia scale.

Michelle Lyons: (19:28)
If you can get somebody to fill out these before they come in to see you, or just get them to come in, you know, 10 or 15 minutes early and sit in, in their waiting room and go through some of these questionnaires, I think then you can go through them together as a team, as, as therapist and patient and say, look, well, I'm, I'm, I'm looking through this, the, the pain catastrophizing scores, you know, the, this questionnaire here, and it looks like you're having a lot of anxious anxiety about this. And then that kinda steers where we're going to go in terms of anxiety, reducing strategies, mindfulness, breathing, yoga versus somebody who's maybe got strong depressive, um, trends in their screening questionnaires. And those are the people that we want to find out. What's bringing them joy. Can we get them moving again? Because we know that movement, um, and exercise in general, fantastic.

Michelle Lyons: (20:23)
In terms of working with mental health parameters now, not instead of working with a mental health professional, but as an adjunct, too, particularly from the realms of, of app pelvic health perspective. So using these kinda screening questionnaires and having those conversations can really guide what sort of psychosocial benefits someone's going to derive from a particular avenue of discussion with them, you know, are they afraid of moving? You know, if you're doing something like the, the TKs to see, you know, what is the fear of movement? Okay. So how can we decrease this fear of movement? Can we find a movement that doesn't hurt that doesn't provoke prolapse symptoms that doesn't provoke leaking and use that as our foundation to restore confidence and movement to bring back resilience, um, and to maybe find a movement practice that they actually like and enjoy, because that's really the key, isn't it? When it comes to reintroducing movement, it has to be something enjoyable. That's nonthreatening, that's non no deceptive. That's really going to expose them to all the benefits that a regular exercise strategy can bring mm-hmm

Lindsey: (21:35)
Oh, Michelle.

Michelle Lyons: (21:37)
Oh,

Lindsey: (21:41)
I mean, what I particularly love about what you said was how you illustrated the partnership that is evident from the moment before they walk in the door. So with these cases of these outcome measures, and I, I, you know, talk about them in my OT pioneers course that I've been offering since 2018 is that we, first of all, these, this, this comes in the packet of forms right along with the pelvic floor questionnaire, anything else forgiving? And what I love about this is from the very beginning, the first introduction that the client has to our practice to us as a therapist is, wow, they're asking questions that no one else has asked me before I'm here because I'm leaking urine. Why does he, or she care that I'm anxious or that I might be afraid of movement. And it starts to get them curious. And it starts to set the, the page for perhaps the experience they're about to walk into.

Lindsey: (22:34)
And they're, they are more open minded maybe to suggestions around, well, let's try yoga, right? Cause we've all had those clients that have come in who said, but I'm here because I have prolapse symptoms. Why are we doing some gentle restorative movement? Mm-hmm  I thought we were gonna be doing this. So it already, it brings them into the fold from the beginning. And then you talked about how you're sitting down there with them, reviewing the questionnaire, also bringing it to that next level of collaboration and problem solving together, which is mirroring that skill that they're then gonna continue while they're seeing us. And for the, for the lifespan right after they're seeing us this idea of stopping, checking in, what am I feeling? What could serve me today?

Michelle Lyons: (23:16)
Yes.

Lindsey: (23:16)
I think it's such a pivotal part of our role. Um, and that just, that also illustrates burnout and, and care and care for ourselves by asking these kind of questions and stopping and connecting the dots. That was so beautiful.

Michelle Lyons: (23:30)
Oh, thank you. Um, you know, I, I just think it's the evolution of where I, where I think, you know, uh, pelvic rehab needs to go just actually yeah, expanding beyond kind of just a very tissue centric approach. Mm-hmm

Lindsey: (23:44)
, that's actually was my, my second to last question for you. So we'll, we'll go there now, unless you feel like we've, we've done this one, but basically I wanted to know where you feel the pelvic health field is growing into next.

Michelle Lyons: (23:57)
Well, yeah, I mean, as I said, just to really, for us all to be, you know, psychologically informed in our practice approach. So I'm not saying that, you know, we want to be psychologists, we, we can't separate the psychosocial from the bio. You know, we just can't focus on tender points in OB internists on the left, you know, we've really got to look at, you know, so how are you sleeping? Yeah. You know, um, and particularly, I think if we're looking at, at sexual health as part of pelvic rehab, um, we've really got to look at all the different parameters in around there. If we're looking somebody who's recovering from trauma, whether that's sexual violence or recovering from cancer, or, you know, uh, a, a road traffic accident, because you know, all of that is going to be held in the body mm-hmm . And unless we deal with that, there's really, you know, yes, we're going to be able to calm things down in session, just maybe using a tissue based approach.

Michelle Lyons: (24:59)
Are we going to get the best long lasting, you know, results for the person that we're working with? I don't think so. So being able to, to really connect with a person on an individual level, to listen to their story, to really ask questions about their life and to come up with this kind of bespoke tailored approach yes. To their issues. So we're, we're moving away from protocols, you know, and recipes. And we're really able to, as I said, just come up with a very, very tailored individual and equals one approach for the person in front of us. And for me, just because pelvic rehab is such a psychologically sensitive part of healthcare, I think, you know, again, all the things that we've talked about, whether that's, you know, using screening forms, a polyvagal approach, mm-hmm, , um, movement practices, mindfulness, whatever works for the person in front of you.

Michelle Lyons: (25:52)
So it's inherent upon, it's really so important that we have a good toolbox yeah. That we can, you know, we have option a, B or C that we can try with a person. You know, I only have option a, if that doesn't work, I'm out of ideas for you. You know, we we've really got to be able to, to look at lots of different things. Is it breath work? Is it Pilates? Is it strength training? You know? Um, is it, is it walking, is it getting back to running again? Is it resuming sexual activity? What, what matters to you? And let's do some, some goal setting together let's, you know, let's really kind of, you know, get quite detailed in what your wellness vision is for yourself. And then what can we do to reverse engineer that mm-hmm  so that we're addressing all the aspects of your life

Lindsey: (26:41)
Mm-hmm  exactly. And, you know, I support a lot of students who are just getting into pelvic health. And I, I think that what you've just described and what I often described to them, which is very similar, that can feel a little bit intimidating, right? I think when we're new in something, we crave the recipes, we crave the point a to point B equals C. But what I always tell my students is actually the recipe for long term happiness in this profession is this bespoke, intellectually, very curious, you know, enthusiastic approach around really sitting with a client in front of us. And actually I'm gonna be so bold as to say, OTs are actually exquisite at building rapport and developing that therapeutic relationship. So if we can get away from that sort of, you know, very like protocol driven and really lean into knowing those tools are gonna come for us. Yes. Right. That, that we actually have everything we need inside us. And time over time, we're gonna develop those tools to be able to support our client to its fullest

Michelle Lyons: (27:42)
100% degree.

Lindsey: (27:44)
. So Michelle, you are definitely a lifelong learner. Uh, you know, as I said in the intro, you've been a PT since 1994, but you really seem to reinvent yourself, which I admire so much. Uh, you've already mentioned, you know, you've taken a Pilates and yoga teacher training. You've done mindfulness as a therapeutic intervention, and you're even taking a postgrad study in health coaching and nutrition. And what I would love to know is what would you have liked to have told yourself, let's say in your first year of practice that you know, now

Michelle Lyons: (28:21)
Relax, , it'll all work out. You don't have to know all the things straight away that most of the time. And I'm going to, to quote my, my friend and colleague, bill Taylor here. Um, if you take a really good history, the patient will tell you what they need for successful treatment outcomes. So definitely listen more than you talk and, and just breathe.  it's all going to be okay.

Lindsey: (28:51)
perfect. That is so perfect. I once heard you describe yourself as a book nerd, and I knew at that exact moment that you were my kind of person, um, what books have you been most inspired by lately?

Michelle Lyons: (29:06)
Ooh, that's a good one. Um, do you know, from a pelvic health perspective, there are three that I find myself consistently recommending to, to patients. Um, and they would be Sue Croft is an Australian physio who is also a good friend and colleague Sue has some excellent books on pelvic health that are patient facing, um, on pelvic floor essentials and recovery after pelvic surgery. And those they're simple, easy, easy to access information. So I'm big fan of those. I love Nicole CO's book, the interstitial cystitis solution. Again, demystifying a really scary subject for a lot of people. Um, oh, I'm gonna throw in fourth. I love beating endo by Amy Stein and Iris Orbach. Again, demystifying all the things that we can do to help people with endometriosis live well and for postnatal people out there. Um, again, another , I'm lucky that I have so many clever friends.

Michelle Lyons: (30:16)
Um, Emma Brockwell is a UK physio. Um, who's written this excellent book called, uh, why did no one tell me about postnatal recovery and dealing with issues like incon and pelvic organ and prolapse after you have a baby? Because I just feel for so many new moms out there, once that baby's on the outside, it is all about the baby. You know, you barely get a look in, you know, and there's so much isolation and fear around pelvic health issues. Um, I think particularly in the postnatal period, um, I would say really during those first two years where there's so much change happening, whether they're dealing with, you know, bladder issues or diastasis, there's so much tissue remodeling and potential going on during that time, but nobody's really talking about it. And Emma's book is one that I buy for all, all my, all the people I know who've just had babies, uh, spoiler alert. This is the book that I'm going to get for you. Why did no one tell me by Emma Brockwell?

Lindsey: (31:20)
Mm, fantastic. Oh, I love that Michelle. I am. So I am so incredibly honored just to hear you're of such an eloquent way of talking about these things that are, are sort of, we live and breathe as pelvic core therapist. You know, those of us that are just so passionate about this field. And I mean, I think I heard you say this on another podcast and I couldn't agree more. It's like when I stepped into this field and I, I realized it in my off time, this is the book. These are the books that I'm reading. These are the topics I'm, you know, listening to it's like, I know that I'm in the right field because it just continually lights me up. And you really, the way that you speak about our field really does that for me as well. So I am, I'm so honored to have had this time with you. And thank you so much for being on this podcast.

Michelle Lyons: (32:07)
Oh, it's been an absolute pleasure, Lindsay. Um, you know, thank you for all you're doing, because I think this is such an important topic, but I think it's such an important format as well, because, you know, podcasts just make information so accessible. And I think particularly podcasts like this, where it is interdisciplinary mm-hmm , um, even though I would say we both fall under the umbrella of being pelvic health nerds. Um, I think just being able to talk about these things and seeing the commonality that we have, um, as, as different healthcare professionals, but again, sharing this common goal to help women live well and, and really to deal with so many of these pelvic health issues, which are so limiting for so many people, um, that we have solutions for, you know, that there's no need to suffer because almost all of these issues are going to be fixable and it's to start the conversation. Absolutely. But also for us to be more visible in our communities, because I think sometimes what can happen is we are superb at talking to each other. Yes. And I think maybe our communication skills with, uh, quote unquote normal people could, could maybe improve a little bit, um, to get the word out that you don't have to suffer with leakage or pelvic pain or prolapse issues that there's so much that can be done. Um, go see your pelvic health therapist.

Lindsey: (33:33)
Beautiful. Thank you so much, Michelle.

Michelle Lyons: (33:35)
Ah, pleasure. Thanks for having me.