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Beaumont’s WISH: Cutting Edge Care for Women

Women’s health is no longer just about periods, pregnancy and menopause. A greater awareness and understanding of additional nebulous or unspoken conditions are garnering more attention and research dollars from those dedicated to understanding and improving women’s health. One such subspecialty of women’s medicine involves investigating the causes, effects and care of diseases that affect the pelvis.

At Beaumont Hospital in Royal Oak, a new and highly unique program called the WISH program, is dedicated to seeing and treating women of all ages who suffer from chronic pelvic pain, discomfort during intercourse and a host of other symptoms that are attributed to this class of disorders.

Donna Carrico, a licensed nurse practitioner, presides over the WISH program. It is by no coincidence that the acronym of the program, which represents Women’s Initiative for pelvic pain, and Sexual Health also holds additional meaning for the women that come to seek treatment from the program itself.

“Most women by the time they see me have met with four or five other health specialists so they truly have a ‘wish’ to feel better,” says Carrico.

The Conditions

The majority of women who come to the WISH program are between the ages of 18 and 65 but, there also women who fall above or below these ranges who receive care and treatment under the guidance of Carrico. Once doctors have ruled out diseases like endometriosis or ovarian cysts, they are often referred to the WISH program.

The most common conditions that Carrico treats are painful bladder syndrome (PBS), chronic pelvic pain and vulvodynia. Painful bladder syndrome is also referred to as interstitial cystitis, a name for which it was previously called. There is no cure yet for these conditions but there are treatments that can help to alleviate some of the condition’s pain and symptoms.

Chronic pelvic pain is pain that primarily affects adult white women and includes pain that lingers for more than six months. It’s symptoms include involuntary contractions of pelvic muscles, burning, itching, irregular and painful periods and possible low back or abdominal pain. The emotional symptoms like anxiety and depression must be included too in the understanding and treatment of this disorder. It is estimated to affect approximately 1 in 7 women in the U.S.

According to The International Society for the Study of Vulvar Disease, vulvodynia is chronic vulvar discomfort characterized by perineal burning, stinging, irritation, or rawness. Pain during intercourse and a heightened sensitivity to clothing or touch are also hallmark symptoms. Since its diagnosis is relatively new, data on its prevalence and incidence cannot be accurately estimated.

Painful bladder syndrome involves discomfort in the bladder and surrounding pelvic region. Symptoms include the urgent and frequent need to urinate, painful periods and discomfort during intercourse. Researchers are beginning to investigate the possibility of a hereditary component to PBS and the presence of a particular substance in the urine that blocks the normal growth of cells that line the inside wall of the bladder. It is estimated that 90 percent of the 700,000 Americans living with painful bladder syndrome are women.

Care

Currently, Beaumont’s WISH program is the only one of its kind in Michigan and one of just a few throughout the entire country. Given its specialized focus, Carrico sees women who travel from other states in addition to those local to the Detroit area. In order to accommodate their travels, Carrico does as much as she can with them during their appointments.

“I’ll create a plan-of-care that includes an arsenal of tools including educational resources so that they don’t have to continue coming back for follow-up visits,” says Carrico.

Most women who make an appointment will first receive a comprehensive questionnaire that chronicles their complete medical history starting from birth. Carrico requests that the woman complete the questionnaire in the privacy of her own home since it is so involved and thorough. Once the questionnaire is complete, Carrico’s initial exam and consultation takes between 90 minutes to two hours.

This generous amount of time that can be spent with each patient is in part due to its funding source. The WISH program receives its funding from the Ministrelli Program for Urology and Education. The need for the WISH program was recognized when the urology department at Beaumont began to see large numbers of female patients with pelvic disorders. It soon became apparent that a more advanced and specialized team of practitioners was needed to provide care and treatment to women affected by these conditions.

The Cause

The causes for these conditions continue to baffle medical professionals. But during Carrico’s thorough questionnaire, she noticed that half of her patients had experienced some sort of sexual abuse in their lives. Now she encourages all medical professionals who see pelvic disorder cases to routinely screen for a history of sexual abuse. She also has a team of psychologists that the individual can work with if they would like additional support in processing the trauma of the abuse.

Since it is such a unique and specialized program, clinical research trials are routinely conducted under the directorship of Carrico. Her findings, including those on sexual abuse, have been presented at conferences around the country and published in many prominent medical urology journals.

Treatment

During the consultation, Carrico works with each patient to create a treatment plan that is individualized to not just the woman’s condition but also her lifestyle and treatment choices. For instance, some women prefer to start out by taking medication while others prefer to adopt alternative treatment modalities like acupuncture, which has shown to reduce pain and discomfort and many of the pelvis conditions. Other treatments include physical therapy, which is conducted by a pelvic floor physical therapist that works exclusively with women who experience pelvic pain.

The WISH program also relies on guided imagery techniques to help the woman relieve pain. Studies suggest that guided imagery or visualization techniques can help individuals respond to chronic pain with less reaction and improved coping skills. The program has created a guided imagery CD that is available to anyone who has vulvodynia or painful bladder syndrome.

Diet and lifestyle modifications and other at-home treatments can also comprise the components of the plan that Carrico outlines for each patient.

Looking Ahead

In the future, Carrico would love to see the WISH program expand so that all areas of care are available to the patient in one setting.

“Our goal is to create a center where clinicians, physical therapists, psychologists, and acupuncturists are on hand to provide care to each patient,” says Carrico.

If you, or someone you know, is living with pelvic disorders encourage them to seek help at a programs such as WISH.