A Passion for Healing
Nov 01, 2012 07:39PM
By Beth Davis
Dr. Robert Echenberg has spent his entire career—over four decades—in women’s health, including over 30 years as an obstetrics/gynecology specialist (most of which was spent in practice in Bethlehem). Over the years, his interests have been varied, but, above all, he has always been passionate about collaborative and integrative care. This passion has served him well at the Institute for Women in Pain, one of the first privately owned, multi-disciplinary practices specializing in the assessment, diagnosis and treatment of chronic pelvic pain (CPP) that he established along with Executive Director Alexandra Milspaw.
For him, this new professional endeavor first began to take shape in 2000, after he returned from New Mexico, where he had spent five years working for an indigent-based clinic. He was asked to establish a non-surgical program for women with chronic pelvic pain for a hospital in Bethlehem. At the time, he had now idea just how rewarding an experience it would become.
Echenberg developed an approach and a model for assessing, educating and treating women with a wide variety of painful symptoms known, in total, as CPP. “Lower abdominal and pelvic pain or discomfort is one of the most common reasons for a visit to the emergency room,” says Echenberg. “Statistics say that 60 to 70 percent of those are acute pain, but they leave with no diagnosis.”
He admits that during his years as a gynecologist, he believed—as he had been trained—that the cause of female pelvic pain was limited primarily to endometriosis, ovarian cysts, pelvic infections, adhesions and others. If those conditions were ruled, out then the patient would be sent off to the urologist, gastroenterologist, low back specialist, family doctor, chiropractor, orthopedic doctor and even to the psychiatrist.
“Women were, and are, being told that nothing is wrong and there’s nothing further that can be done,” he explains. “Patients get upset and anxious and are treated as hysterical young women that may be exaggerating their symptoms. They are made to feel as if they are crazy but the reality is, 30 million women in the U.S. have some type of pelvic pain. They are not alone.”
Through the development of his program, Echenberg learned that there were many other pathways to pain. “I became more familiar with urinary bladder and lower bowel dysfunctions, because at least 80 percent of CPP is triggered by non-gynecological functional disorders such as Irritable Bowel Syndrome (IBS) and Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC), as well as innumerable nerves, muscles and ligaments that combine to make up the rest of the supportive structures of the pelvis.
The goal of the Institute is to help these women who have seen numerous doctors and had numerous procedures—many of whom have given up hope—get their life back. “Many doctors just aren’t informed about these issues,” explains Milspaw. “The women are told to deal with it or that’s it all in their head. By the time they find us, we help them connect the dots.”
Milspaw shares Echenberg’s passion for guiding women toward their own healing. She is currently earning her doctorate in human sexuality and is certified as a master practitioner in NeuroLinguistic Programming, Emotional Freedom Techniques (EFT) and mindfulness-based stress reduction trainer. She has been working with patients suffering from chronic pelvic pain for two years, focusing on the counseling and education of mind/body relaxation for stress and pain management, and has been running workshops for women for more than six years.
“These women often experience anxiety and depression because they are in constant pain, but nobody can tell them what’s wrong with them,” she says. “We often see the worst of the worst, so it’s incredibly gratifying to help give them their life back.”
Very specific treatment regiments were developed including specialized medications, dietary changes, bladder and bowel therapies, referral for manual pelvic floor physical therapy, emotional counseling, as well as recognizing and treating many of the specific nerve pain issues. They have now seen patients from 11 different states, as well as a few international patients.
Beyond the obvious—helping patients improve—Milspaw and Echenberg also share a commitment to education. In fact, through the Alliance for Pelvic Pain, they will host a patient-centered, two-day educational retreat, in April 2013, along with three other practitioners, that gives a comprehensive overview of what women need to know and where they need to go to get the help they need. The weekend will provide a solid foundation of knowledge, skills and treatment modalities that will help patients get back on track toward managing and healing their chronic pelvic pain.
For both, helping people have a better, more comfortable life is the ultimate goal. That often starts with helping women feel safe, since they are often on guard. “If they can feel safe with us, that is the first step in feeling safe with others,” says Milspaw.
The Institute for Women in Pain is located at 623 W. Union Blvd., Ste. 5, in Bethlehem. For more information, call 610-868-0104 or visit InstituteForWomenInPain.org.