Latest / Pelvic PT Rising / Revolutionizing Male Pelvic Health: An Interview with Jake Bartholomy

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Revolutionizing Male Pelvic Health: An Interview with Jake Bartholomy · Pelvic PT Rising

• 0:02
  Speaker 1: In the last 10 years, our field has gone from an unknown specialty to a household name.
• 0:09
  Speaker 1: This brings unprecedented opportunities, but we need to rise up to meet them and give our patients the care that they deserve.
• 0:17
  Speaker 1: In order to help others get better, we need to be better.
• 0:23
  Speaker 1: This podcast will help you to become more confident with your patients, more successful in your practice or business and a leader in pelvic health, and we're going to have some fun along the way.
• 0:36
  Speaker 1: Join us as we rise together.
• 0:39
  Speaker 1: We're Jesse and Nicole Cozine, founders of Pelvic Sanity Physical Therapy and the creators of the Pelvic PT Huddle, and this is Pelvic PT Rising.
• 0:54
  Speaker 2: Hey guys, welcome back to another episode of the Pelvic PT Rising podcast with Jesse and Nicole Cozine.
• 0:59
  Speaker 2: Hey, nicole, hello.
• 1:00
  Speaker 2: I am so excited for our conversation today with Dr Jake Bartholome.
• 1:04
  Speaker 2: He is a trailblazer.
• 1:06
  Speaker 2: He is someone who's been a clinician and educator and I cannot wait to hear him talk at Pelvic Con 2023.
• 1:13
  Speaker 1: Yes, i'm so excited for you guys to hear this interview with Jake.
• 1:16
  Speaker 1: I think that he's going to help you all If you are in this category of folks that are in pelvic rehab and that have not treated men or added male pelvic health to the populations that you treat.
• 1:31
  Speaker 1: I'm excited for you to hear Jake talk because I completely understand and respect anybody who does not want to treat a type of diagnosis or certain person in the population.
• 1:42
  Speaker 1: But if you're on the fence because you are not confident, because you haven't had mentorship in this area, because you took 2A a long time ago and you just don't feel quite comfortable or you're a little bit trepidatious about the unknown of treating this population, i'm really excited for you to listen to what Jake has to say about that in this episode.
• 2:04
  Speaker 2: Yes, it's an incredibly underserved population, as he points out.
• 2:07
  Speaker 2: I think he has a really unique perspective as a male treating primarily men, to be able to share with us.
• 2:13
  Speaker 2: I am really excited for you guys to listen to it With no further ado.
• 2:17
  Speaker 2: Here is our interview with Jake Bartholomew.
• 2:19
  Speaker 2: Hey guys, we're so excited to be here with Dr Jake Bartholomew, pelvic floor physical therapist, pelvic con speaker.
• 2:30
  Speaker 2: Jake, thanks so much for being with us.
• 2:31
  Speaker 2: Thank you for having me.
• 2:33
  Speaker 1: Well, Jake, I am really excited for everybody to get to know you a little bit on a more personal level, but I am really excited as well to speak with you here about the field in general, about being a male in this space of Pelvic Health Rehab.
• 2:51
  Speaker 1: I think that you can give us so much insight into how the field has progressed and where we still need to go.
• 2:59
  Speaker 1: But first, Jake, can you give us just the little rundown of how long you've been practicing, where you live, what's been happening in your life over the last few years and what you're doing now?
• 3:13
  Speaker 3: Sure, i am 50 years old now and I've been in Seattle 23 years since I finished PT school at Slip Re Rock University in Pennsylvania.
• 3:22
  Speaker 3: I started in general outpatient ortho but we had an awesome pelvic health PT that I sat next to doing notes next to, and so I just kind of threw I don't know just by sitting next to, where I kind of learned a little bit about pelvic health that way, because I was not exposed to it all in PT school or on any of my rotations.
• 3:43
  Speaker 3: I had no idea.
• 3:44
  Speaker 3: And so sitting next to her, i just became more aware that it was a thing and that she treated all pelvises.
• 3:51
  Speaker 3: And then in 2008, there was a new male pelvic health continuing ed course came out and it was hosted first here in Seattle And she was going to be a lab assistant for it.
• 4:02
  Speaker 3: And she gave me this talk like hey, jake, will you please consider taking this course?
• 4:08
  Speaker 3: And then she because she had a four month wait list at the time for all new patients And she's like you know, you could help if you're willing to treat men, they could get in right away.
• 4:17
  Speaker 3: And then I could just get other people in sooner off my wait list.
• 4:20
  Speaker 3: And she just saw the look of poor on my face And she's like just think about it or maybe just take the course, and then I'm here to hold your hand and mentor you.
• 4:30
  Speaker 3: But even if you take the course and decide you don't want to, that's fine too.
• 4:33
  Speaker 3: So I went ahead and took the course, scared to death going in there, but then came out, i think like most people going, okay, that's not so bad, i can do this.
• 4:42
  Speaker 3: So that started my pelvic health journey in about 2008.
• 4:46
  Speaker 2: So then, you started seeing some male patients at the clinic, when did you realize like, hey, this is actually what I want to do, like I'm a pelvic health therapist now.
• 4:56
  Speaker 3: Because I kept seeing all parts of the body And then but quickly realized there's very, very few male PT's treating pelvic floor in Seattle or, and then I started realized even broader than that, there's just not that many, and so I stepped away.
• 5:13
  Speaker 3: When our first son was born and I took a year off to be home with him And then when I decided to go back very part time, i decided to only see pelvic floor because I didn't want to get fill up my schedule with knees and shoulders and necks.
• 5:29
  Speaker 3: In case a guy wanted to see a male PT, i wanted to be available.
• 5:33
  Speaker 3: So I've limited my practice to that since 2015.
• 5:39
  Speaker 2: Got it and then can.
• 5:40
  Speaker 2: i would love to know what it was like and how you've seen it potentially change or not change, but i would guess at continue education courses, especially starting off.
• 5:51
  Speaker 3: like you were probably the only male in the room, yes, yes, and luckily connet companies were changing their policies by that point to where i didn't have to bring my own vagina to a course or my own Ain't us to the course.
• 6:07
  Speaker 3: Luckily they just realized were adults and could practice on each other.
• 6:11
  Speaker 3: But i think it wasn't too long before that.
• 6:14
  Speaker 3: Or there are other connet companies that still required, and they might even still today some.
• 6:20
  Speaker 3: If you're a male taking any pelvic floor course, you might have to bring your own Lab partner, which just is such a barrier for so many people.
• 6:30
  Speaker 3: I mean, imagine flying to another state to take a class and you have to fly someone with you And the expenses of all that.
• 6:36
  Speaker 3: And if you have any card money it's not covering any.
• 6:38
  Speaker 3: It's all out of your own pocket.
• 6:39
  Speaker 3: So there's just so many barriers.
• 6:41
  Speaker 3: And just what message does that send to?
• 6:43
  Speaker 3: when you say you have to bring your own person, like how welcoming is that trying to get People into the field?
• 6:48
  Speaker 3: because i've talked to these guys who message me saying, hey, what can i take?
• 6:52
  Speaker 3: and so i try to steer them towards some of the ones that Are more inclusive or more welcoming and fewer barriers.
• 6:58
  Speaker 3: So that's one of the big things is training.
• 7:02
  Speaker 1: Yeah, and you know, i think actually what's funny you say that cuz i got first trained in pelvic floor in two thousand and six And there was one male in our class and he had to bring somebody and that was like what it was and it was like they pushed him to the side, it was like this major curtain barrier thing, and he happened his nurse, his nurse, his wife happened to be a nurse, and so he was right but you know, it was all very much in this back corner.
• 7:33
  Speaker 1: And then there was a few of us, me included, who I mean, you probably look at her all the time and it's like that's fine, but like the whole point of going to a course like that is that you need to practice on multiple people, like That's where you get that experience.
• 7:47
  Speaker 1: And so there were a small few of us i think it was like three of us that were like hey, you can come over here to our group and we ended up creating like a group of six That, and we were just like that's fine, and the instructors are all weird about it.
• 8:01
  Speaker 1: Oh no, we can't do that.
• 8:02
  Speaker 1: And i get well on lunch we were like come on over, and then we took our pants off.
• 8:07
  Speaker 1: you know it's like, but your point, that must have been like a very small window of time.
• 8:11
  Speaker 1: you know, right between when you and i were getting in that same learning phase that I'm glad they're changing that rule at least some companies are, so that's great.
• 8:20
  Speaker 2: Correct, right, yeah, there's still a lot more to go totally yeah and then just to kind of follow up with that, because i'm sure that, as being a minority in pelvic health were, there must have been times where you didn't feel welcome or felt that apprehension, anything stand out.
• 8:37
  Speaker 2: That was just like one of those moments like i literally can't believe this is happening.
• 8:41
  Speaker 3: Yeah, so that very first course i took it was here in seattle, like i said, my co-worker was my lab assistant and there will happen to be one other male in there, and it was a learning how to treat men course, and so it really was a non issue, luckily.
• 8:59
  Speaker 3: So my very first experience was non issue, piece of cake, like No one had to be anywhere separate in the room and i think the instructors are even, i mean, just super welcoming, like hey, do we have two guys in here?
• 9:10
  Speaker 3: you know great thing from the get go.
• 9:12
  Speaker 3: And so then after that course, i am like, oh, i, you know, i still a lot of people taking your very first course.
• 9:19
  Speaker 3: You're still pretty scared to go treat the next thing on monday.
• 9:23
  Speaker 3: I'm you're like do i really have the tools, do i have this down?
• 9:26
  Speaker 3: and so i was hungry to take more, and so then i signed up for a ball colorectal focused course next, and it was next offered, you know, like four months later In the midwest, and is the same two instructors as my first course.
• 9:42
  Speaker 3: And so i was like this is cool, you know i'll know two people, but otherwise i just, you know, just going in naive, because my first experience was great and i'm being in seattle and being around a lot of smart public health pts, all good.
• 9:55
  Speaker 3: So i fly to this course and walk in day one and go walk in this big room.
• 10:03
  Speaker 3: I just felt like the temperature drop and these icy, stab stabbing stairs like going through me, like it was so palpable.
• 10:14
  Speaker 3: I was like what is going on, like what just happened when i walked in the room and then it took me a minute to process that, eight, the time we're living in be the midwest no offense to the midwest, but i hear consistently that there's a very different feel about openness and draping and, you know, whatever in these courses.
• 10:35
  Speaker 3: And i was just clueless to it and it was just such a shocking feel like no one said anything, but it was just palpable feel.
• 10:45
  Speaker 3: I sat in the back, away from anyone at the time.
• 10:48
  Speaker 3: I got there slightly early and so luckily then, not really thinking about a better future, i did this on purpose.
• 10:55
  Speaker 3: I would go early and sit alone So that anyone that sat by me chose to sit by me.
• 11:00
  Speaker 3: They weren't being, i didn't sit next to you know the middle of three, forcing them suddenly to be my lab partner, friend or whatever, and so luckily, someone sat for me from who has happened to be from washington, also a different city, who was just totally open and glad i was there.
• 11:16
  Speaker 3: And then also, luckily, as soon as the instructors started speaking and her duck and introducing themselves, they said, okay, we want everyone to introduce themselves.
• 11:26
  Speaker 3: Why you here, why you taking this course?
• 11:27
  Speaker 3: and they started in the back and so Pretty quick off, like you know, i was able to say who i was and i was taking this course so i could learn that just further my Education on.
• 11:39
  Speaker 3: You know, i'm really focusing on penis, having pelvises, yeah.
• 11:43
  Speaker 3: And then, and luckily, as soon as i spoke and introduce myself, the instructors like always so you guys are also lucky Have jake here and you actually have a male pelvis to look at, in a prostate to feel, and they're just and the temperature warmed up a little bit, like it got better, by the instructors being so positive and enthusiastic about it.
• 12:02
  Speaker 3: But still, i learned later that, like i think, several participants did not want me to be their lab partner and told the instructors, a, we don't want them to be my lab partner.
• 12:13
  Speaker 3: And And then the same thing happened years later when i took pf one.
• 12:17
  Speaker 3: You know, just truly the giant having Focus course.
• 12:22
  Speaker 3: And i took it because i realized, you know, if i want to be opened up all pelvises, if i see a trans patient and i want to know All the possibilities and be able to treat that, and because, sure enough, i've had trans feminine post bottom surgery, helmess is to work on them.
• 12:38
  Speaker 3: So glad i had one.
• 12:39
  Speaker 3: But same thing, it was icy, cold and people purposely avoided me and not want to be my lab partner and others were like, hey, i'm in, you know.
• 12:48
  Speaker 3: Yay, i get to learn more from someone else.
• 12:51
  Speaker 2: Yeah well, i'm sorry that you had to go through that and i'm sure that there's more times than that that you've kind of felt Unwelcome in certain forms of fashion.
• 13:00
  Speaker 2: Is that as a person?
• 13:02
  Speaker 2: does that diminish your desire to be in the field, or does that fire you up, like make change and like be that trailblazer?
• 13:09
  Speaker 3: It fired me up because i was already teaching at that time and that just made me realize how much further we have to go and to try to educate.
• 13:19
  Speaker 3: And I'm not I certainly not trying to make everyone change their minds.
• 13:25
  Speaker 3: I understand there's religious reasons, there's past trauma, like there's a lot of reasons where certain people are not going to treat a certain population And I totally respect that.
• 13:34
  Speaker 3: But there's a lot of people who just have a little fear or anxiety or they're just don't know, and those are the ones I'd like to encourage to really broaden their education and expertise, because I'd say in my mind that's the majority out there I think it's a small amount that really have hardcore religious or their spouse says no, or past trauma.
• 13:58
  Speaker 3: I totally, totally respect that.
• 14:00
  Speaker 3: That could be too much.
• 14:02
  Speaker 1: It's a great point to bring up that distinction, because I do feel like everybody has the right to treat who they want to treat.
• 14:08
  Speaker 1: But there is there's that unknown that the people that are a little bit fear of the unknown or a little bit fear of what might happen, or stories that they've heard in Facebook groups and like thinking that those anomalies that we're talking about in the Facebook groups of that one person who was inappropriate, like that doesn't happen the majority of the time, i feel like.
• 14:32
  Speaker 1: and so I just to get that word out a little bit more and to know that it's okay to be a little trepidatious at first and that you seem to find a good mentor in someone that can, that's willing to sort of walk that with you and be there.
• 14:46
  Speaker 1: I think that that's great And you are one of those people that are, like Jesse said, trailblazing in that way and being that male person that we can like look up to in our field.
• 14:57
  Speaker 1: So really appreciate the work that you've done so far.
• 15:00
  Speaker 1: all the teaching that you've done, and just being present and being able to have you speak at Pelvicon, i think is really going to elevate that whole side of our specialty field.
• 15:10
  Speaker 1: I'm really excited about that.
• 15:12
  Speaker 2: And I'm wondering too, about just Jake, what you think about it being a little bit of the way that education is done, because I know you've taught.
• 15:19
  Speaker 2: I mean you've obviously gone through a lot of continuing education courses, but you've taught.
• 15:23
  Speaker 2: You've taught at universities.
• 15:24
  Speaker 2: I feel like part of the problem is almost systematic, like what you just said, that PelvicFloor 1 is a vagina focused course.
• 15:31
  Speaker 2: That may be all that somebody gets in their initial training.
• 15:35
  Speaker 2: They may only take that and then go back and start treating.
• 15:37
  Speaker 2: They may not have the ability to take another course for a period of time.
• 15:41
  Speaker 2: Do you feel like that?
• 15:42
  Speaker 2: the fact that we focus on just vagina, not holders vagina?
• 15:46
  Speaker 1: havers For vagina?
• 15:47
  Speaker 1: yes, vagina having folks.
• 15:49
  Speaker 2: In that first course.
• 15:50
  Speaker 2: Do you feel like that kind of sets that trajectory of again people who aren't opposed to treating men but just have never had the experience, the training, and now all of a sudden they spend two or three years practicing only on a female population and then that's kind of where they settle into?
• 16:05
  Speaker 3: A hundred percent.
• 16:06
  Speaker 3: Yeah, yeah, and there's a distinction between or it's just a good point to like whether it's even mentioned or not, like PF1 or, for example, like any introductory to PelvicFloor course.
• 16:17
  Speaker 3: It'd be great if it was at least mentioned and addressed, and just I mean we just need to broaden it even beyond, like I alluded to earlier, all pelvises right, because they're not all going to be vagina having or penis having.
• 16:31
  Speaker 3: There's a growing and growing population in between and all in between, not you know, and so I think some of the intro courses are being rewritten and being more inclusive and they might be more heavily dominant in one area, which is totally fine, but at least let's expose everyone to all the possibilities and let them know.
• 16:53
  Speaker 3: And there's great online options, like you know.
• 16:56
  Speaker 3: It's not the same, of course, as a lot, you know, a hands-on lab, but educating these providers as to all the possibilities And there's a lot you can learn online, and that you you know, because a lot of these therapists, i think, that will listen to this and be a PelvicCon, might be one of the only people in their area.
• 17:17
  Speaker 3: They're from small town, they might be the only one, and that's kind of my concern with if they limit their practice and they really won't see a certain population, i'm like, ah, where's that population going to go?
• 17:28
  Speaker 3: Because I think legally you have to be treated.
• 17:32
  Speaker 3: Even if you do online telehealth, the provider still needs to be in your state for most, you know, if it's for insurance or just state law.
• 17:40
  Speaker 3: I mean because you're I mean you're licensed in your state.
• 17:43
  Speaker 3: So that's why I just want to encourage you know, every PT I meet to be open, because even if they don't do hands-on like you, can educate that patient so much if you get the training at least.
• 17:55
  Speaker 3: So, yeah, so back to being long-winded again.
• 17:58
  Speaker 3: Getting back to let's in those first courses or every course, let's at least mention all the options and get people at least thinking that plant, that seed.
• 18:09
  Speaker 1: Yes, 100% agree with that, and then can we just, in that same vein, i think what also gets missed quite a bit in some of these introductory courses and it seemed sometimes more of an advanced topic or something that you do when you get more comfortable treating right.
• 18:26
  Speaker 1: I feel like there's this overall theme of like okay, well, just get comfortable treating a vagina and then we can branch out.
• 18:33
  Speaker 1: Also, in that same vein, let's get comfortable treating a heterosexual person and then we can branch out into being inclusive.
• 18:42
  Speaker 1: Can you speak a little bit to just the overall fact that gender and sexual orientation is very different And we need to, as providers, be able to speak that language to folks and make sure that every aspect of their pelvic and sexual health is addressed in this each session.
• 19:04
  Speaker 1: Can you elaborate on that a little bit?
• 19:06
  Speaker 1: Do you have any thoughts and feelings about that?
• 19:08
  Speaker 1: from like teaching to treating to what does that make you feel like?
• 19:12
  Speaker 1: when I say stuff like that?
• 19:13
  Speaker 3: I mean I guess you're just touching on the overall progression that has been so much better, like the last five years, of inclusive language, right?
• 19:22
  Speaker 3: Yes, Because we need to get away from, but it's so hard.
• 19:26
  Speaker 3: I see both sides and I want to be not get angry at people who happen to say a male and a female, but we need to be more inclusive.
• 19:35
  Speaker 3: Well, and the assumptions that go with male and female and heterosexual, right, And when you assume that your female patient is, if she's wearing a ring and says she's married, you don't want to assume that she's having intercourse with a penis And that's often the assumption made.
• 19:52
  Speaker 3: And we need to be so much more inclusive of every patient and come up and there's good language available that it just takes practice.
• 20:01
  Speaker 3: We just all have to practice working on our language, even if because there's a lot of times no ill intent meant, but we can work on that.
• 20:11
  Speaker 3: You know saying all pelivuses and intercourse, and is that intercourse and happen to be in a vagina, a neo vagina?
• 20:18
  Speaker 3: Is it in?
• 20:19
  Speaker 3: is an anal and the rectum.
• 20:20
  Speaker 3: You're just touching on how we need to.
• 20:23
  Speaker 3: We can really still improve our language, no matter what patient, no matter how they fit into old societal norms or not, we can all improve.
• 20:32
  Speaker 1: Yeah, absolutely.
• 20:33
  Speaker 1: And that brings us to our exciting news and the end of the reasons why we're so excited to have you speak at PelvicCon is that we're going to bring some of these topics to light.
• 20:45
  Speaker 1: And so at PelvicCon, jake, you are going to be talking about anal sex, what pelvic rehab providers need to know, and eval and treatment strategies for erectile dysfunction.
• 20:57
  Speaker 1: I'm very excited to be bringing these topics to Pelvicon and to our whole audience.
• 21:04
  Speaker 1: What makes you excited about talking about these topics?
• 21:10
  Speaker 3: I'm super excited because I've never heard them really talked about And I've taken a tiny little online course that's out there and available, but it's just really designed for the general population who might be new to this, and they don't have any dysfunction or any issues.
• 21:28
  Speaker 3: It's just someone that might be new to it And so it's really written for the newbie with no issues, and so I'm excited to bring this to clinicians and just to get it more talked about.
• 21:40
  Speaker 3: Period, because it's always been a taboo topic, right Even in the medical world.
• 21:47
  Speaker 3: I'm guarantee doctors are not asking their patients about anal sex, unless I live in Seattle, where you can find a gay doctor who has a giant gay population, and so of course they're talking about all the things.
• 22:03
  Speaker 3: But outside of that, i realize I live in a bubble and the rest of the US there's not a lot of talk about this, and certainly not from a continuing ed, from an educational, therapeutic standpoint.
• 22:16
  Speaker 3: So I'm just excited And I just might mention this in my talk at Pelvicon.
• 22:23
  Speaker 3: You know, 23 years ago, coming out of PT school, i did not think I'd be standing on the stage talking about anal sex and penises and stuff like there's no way 625 people and you're going to be like.
• 22:34
  Speaker 1: This is what I'm an expert in.
• 22:36
  Speaker 1: This is amazing.
• 22:40
  Speaker 1: But what a testament to how our field has changed, though too right, i mean, i feel like, again, i've been in practice for 17 years like having a topic like this, and this is why Jessica and I wanted to bring you here.
• 22:52
  Speaker 1: You've had some breadth of experience in the field.
• 22:55
  Speaker 1: You've seen how the field has changed.
• 22:57
  Speaker 1: You've been on that leading edge of pushing our field into the being a male provider in that space and then treating all pelvises, and I just feel like I'm really happy that we're going to be bringing that to more folks here.
• 23:10
  Speaker 1: So that is wonderful.
• 23:12
  Speaker 2: Yeah, And then Jake, what about erectile dysfunction?
• 23:15
  Speaker 2: So obviously another kind of taboo topic, like the only thing we ever see about this is like two people in a field with bathtubs taking Cialis.
• 23:25
  Speaker 2: What makes you excited to talk about that?
• 23:28
  Speaker 3: To educate people that there's more than just Cialis treatment, again, to get people talking about it, because so many men don't report it to even their primary care physician for the longest time because it's such a source of shame or they feel emasculated or embarrassed.
• 23:46
  Speaker 3: And so we really need better awareness, better discussions, better information out there, and the earlier the better.
• 23:55
  Speaker 3: Like any issue, right?
• 23:57
  Speaker 3: Like how many chronic pain patients do you see that you're like, oh only they'd come in.
• 24:02
  Speaker 3: You know, two or three weeks after it started And I'm seeing them three years that they've been dealing with it and they won't talk about it.
• 24:08
  Speaker 3: And how much quicker would it gotten better if we'd addressed it a long time ago.
• 24:12
  Speaker 3: And that's what just makes me feel for all my penis-having patients, right, that put off, no matter what it is, but something about that area and they don't want to talk about it, and so by the time they find me, it's really bad.
• 24:26
  Speaker 3: And then the psychological layers on that of depression, stress and anxiety that have built and built because of that.
• 24:32
  Speaker 3: So that's what I'm excited to talk about again talking to clinicians and providers that they can try to address this with their patients And even if that's not what brought the patient, to them, kind of like you guys talked about constipation, right Like that's probably not what brought them into the clinic.
• 24:50
  Speaker 3: But if you guys have the paperwork, or in your subjective interview you start to bring up other things and they're like oh yeah, actually, you know, with erectile dysfunction Someone will say, you know, some of the time I feel like it's only getting 70% hard or sometimes not at all, and I'm like whoa, wow, okay, does your doctor know?
• 25:08
  Speaker 3: Because, a, you know sexual health is part of mental health and healthy lifestyle, but B, is it signifying some cardiovascular issue or neurological issue, spinal cord issue?
• 25:22
  Speaker 3: right Like, so there's, you know, there's some serious red or yellow flags that they might need to be checked out further, if they haven't already.
• 25:29
  Speaker 1: Yeah, absolutely.
• 25:30
  Speaker 1: You know, sometimes I look back at my career and I'm like, wow, when I first was at that hospital program, that was really awesome.
• 25:35
  Speaker 1: We saw a lot of things that we don't typically see a ton here.
• 25:39
  Speaker 1: Just by the nature of what we do, We don't see a lot of Medicare folks, but there we did.
• 25:45
  Speaker 1: I saw a ton of people post-prostatectomy, where that was one of their main concerns.
• 25:49
  Speaker 1: It was like urinary incontinence and erectile dysfunction, And so we were talking about that quite a bit And I've always kept that as part of my subjective exam And, quite frankly, I've kept it.
• 26:00
  Speaker 1: For my cisgender women, heterosexual folks who have painful intercourse, I'm always screening and asking does your husband also have?
• 26:09
  Speaker 1: if they're married, did they also have erectile dysfunction?
• 26:11
  Speaker 1: Because if there is both ends of that too, if your person is having a hard time or not so hard of a time, quite frankly performing, then the sex encounter lasts a little bit longer and there's more friction and all the things, And so I've always kept that as part of our thing.
• 26:30
  Speaker 1: But I'm we're our subjective examination, but I'm really thankful that I had that early on.
• 26:34
  Speaker 1: So again that you mentioned before that we can practice talking about it more often because the more that we normalize it in our own language and what we ask patients, the better everybody feels.
• 26:45
  Speaker 1: right, Then it's not so much of a you know, oh gosh, i'm getting weird.
• 26:49
  Speaker 1: Now you're weird.
• 26:50
  Speaker 1: I'm like just don't make it weird, it's like you know.
• 26:52
  Speaker 1: yeah.
• 26:54
  Speaker 3: Mike say, and even I could say a good anatomy review for clinicians and providers here that I want to give in my talk.
• 27:02
  Speaker 3: But it might also be new information, like, again, you know, i didn't get this in PT school and they made a lot of my con ed.
• 27:08
  Speaker 3: I didn't get very good pathophysiology erections right, like we learn about, you know, the urethra and the pudendal nerve, but we don't learn a lot about the autonomic pathways and where they lie and how, again, as PT is knowing the anatomy, there's a lot more we can treat than we think about this subject.
• 27:28
  Speaker 3: So it's not going to be only educating these providers and them educating their patients, but educating your referring physicians that when you go to market, like hey, let me take a stab at some of your ED patients, not just your pain patients, you know, let me try.
• 27:45
  Speaker 3: You know, especially if there's not the obvious, like I don't know that it is cardiovascular or diabetes or whatever you know, like let's look and see if my skills can address the anatomy and help their ED.
• 27:59
  Speaker 2: Awesome.
• 27:59
  Speaker 2: Well, i'm so excited to have and hear this whole talk that you're going to give a public on on both of these, one of the things that we do and, jake, i know you've heard this on the podcast before, but we do what we call a missing piece series.
• 28:11
  Speaker 2: So from those topics, either individually or just kind of together, what do you feel like a missing piece is around the subjects?
• 28:22
  Speaker 3: Because in general, the missing piece is public health providers treating men.
• 28:27
  Speaker 3: I mean that's almost the whole puzzle is getting them in the door and being open to seeing all palvices in your clinic, and then, like a smaller missing piece is, are you asking about their sexual health?
• 28:39
  Speaker 3: And so this applies both for anal sex.
• 28:42
  Speaker 3: anal play doesn't even have to be with a partner.
• 28:45
  Speaker 3: I had two of my most recent hetero identifying males discuss with me that the toy they used for anal pleasure you know it wasn't even with their partner or anyone else, and I was so glad they felt comfortable talking with me about that One of them it was part of what he thought brought him in.
• 29:03
  Speaker 3: he thought it might have led to a little dysfunction.
• 29:06
  Speaker 3: And then the other one you know we were several issues in.
• 29:10
  Speaker 3: it was more focusing on his ED, was in some pain, but several sessions in he mentioned anal play with the toy, and so I was just so glad that that came up and we could discuss it.
• 29:22
  Speaker 3: And so those are the big missing pieces is that they're not being asked to.
• 29:26
  Speaker 3: but these conditions aren't being asked about either out of a comfort level or ignorance level or just not on your radar.
• 29:33
  Speaker 3: And so I want to put it on people's radars to ask these questions.
• 29:37
  Speaker 2: Awesome.
• 29:37
  Speaker 2: I'm so excited about that for everybody who's going to be with us live at Helpecon, for people who are going to be getting the recording, just to bring more information around.
• 29:45
  Speaker 2: That and that comfort level, i think, is really so important And I'm really glad, jake, that you're going to be bringing that topic.
• 29:51
  Speaker 2: I think it's such an important one.
• 29:53
  Speaker 2: So, before we let you go, a couple of things.
• 29:55
  Speaker 2: One people can connect with you pelvic underscore, floor underscore Jake on Instagram correct, yes, beautiful.
• 30:03
  Speaker 2: So they can follow you to learn more about what you're talking about here With all of our guests.
• 30:07
  Speaker 2: We hit you with a lightning round at the end.
• 30:09
  Speaker 2: So, if you're ready, we're going to start with this question.
• 30:13
  Speaker 2: What is?
• 30:14
  Speaker 2: I know you spent about half of your life in Seattle.
• 30:16
  Speaker 2: What's the most Seattle thing about you?
• 30:19
  Speaker 3: that I compost probably, oh my gosh.
• 30:24
  Speaker 3: Well, yeah, i mean, i don't turn it into soil myself.
• 30:28
  Speaker 3: We did that When our last house we did actually have a big composting bin, but that was before Seattle let you put food waste into your yard waste bin, but then Seattle has progressed to where we can put everything in our yard waste bin, including pizza boxes, and then all food, all meat, everything can go well.
• 30:47
  Speaker 3: So, yeah, that's the most thing.
• 30:49
  Speaker 3: And then the other second thing is probably I'm vegan, and so that that's pretty Seattle.
• 30:52
  Speaker 3: That's Seattle.
• 30:54
  Speaker 1: Oh my gosh, I didn't know any of that stuff.
• 30:58
  Speaker 1: Jesse is always bugging me to like do the right thing with all of the recycle things And you would like to compost, would you not?
• 31:06
  Speaker 2: In theory, I would like to be the type of person who would compost without actually having to do it.
• 31:12
  Speaker 3: So do you guys not have yard waste like just your area?
• 31:16
  Speaker 3: not pick up yard waste?
• 31:17
  Speaker 1: We do, but then I'm like so literal, I'm like, no only if we cut down like some leaves on a tree, that we put that in there.
• 31:22
  Speaker 3: Like I don't put food waste in there.
• 31:23
  Speaker 3: Oh, you're not allowed.
• 31:25
  Speaker 3: Oh, wow, okay Yeah.
• 31:28
  Speaker 1: So California is a little far behind.
• 31:30
  Speaker 1: We are in the red curtain and in Orange County, so maybe, if that's what you're just teasing, right?
• 31:36
  Speaker 1: Okay, jake, do you have any pets?
• 31:39
  Speaker 3: Yes, we have a two year old Bernadoodle.
• 31:42
  Speaker 1: Well, what?
• 31:43
  Speaker 3: Bernese mountain dog and poodle Oh Bernadoodle, No way.
• 31:47
  Speaker 1: So it's he, he or she.
• 31:49
  Speaker 3: He, he identifies as he has.
• 31:51
  Speaker 3: He identifies as he has.
• 31:52
  Speaker 3: I was like darn it Shoot Bad question.
• 31:54
  Speaker 3: He is more of a they, since he can't reproduce.
• 31:58
  Speaker 1: True, got it.
• 32:00
  Speaker 3: No, it's still he, him, he just.
• 32:01
  Speaker 3: Yeah, he him, i don't want to demit it from anyone with a vasectomy.
• 32:04
  Speaker 1: I know right, See, this is my, this is my brain.
• 32:07
  Speaker 1: I'm like take it.
• 32:08
  Speaker 3: I know, but I'm better, i'm working on it.
• 32:11
  Speaker 3: I'm working on it.
• 32:12
  Speaker 1: Same.
• 32:12
  Speaker 1: So is he big, how much is he weight?
• 32:15
  Speaker 3: So it all depends.
• 32:16
  Speaker 3: They could be any size because it depends on the size of the poodle, because Bernese are big dogs but they can use any size poodle.
• 32:21
  Speaker 3: So he's medium, he's about 60 pounds.
• 32:23
  Speaker 3: He's a nice size.
• 32:25
  Speaker 1: Oh yeah, but I had a patient that had like but love Bernese Mountain dogs, he like had like three of them and they were enormous Anyways this is yeah, he's a great combo of that lovely dog without the shedding.
• 32:36
  Speaker 3: That's really awesome.
• 32:37
  Speaker 1: Yeah, cool.
• 32:38
  Speaker 1: All right, what's the next one?
• 32:41
  Speaker 2: What are you most excited about in the field where things are going?
• 32:45
  Speaker 3: Just the fact that things are progressing, that I'm seeing way a broader diversity of therapists getting into the field, identifying as all type of much broader identities getting into pelvic health, and that's what I've really been promoting.
• 33:01
  Speaker 3: when I speak at CSM or I teach, i'm just trying to get more diversity in the field and then more therapists and clinicians open to seeing all pelvises in their practice and educating the provider or the referring physicians to consider PT for so many things.
• 33:20
  Speaker 1: Yeah, Isn't that like the domino effect that we end up wanting to effect?
• 33:23
  Speaker 1: change that way.
• 33:24
  Speaker 1: All right, Jake.
• 33:25
  Speaker 1: last question If you were not in the pelvic health field, if you weren't a PT, if you weren't doing, if you weren't a pelvic floor PT, what profession would you be?
• 33:34
  Speaker 1: What would you be doing?
• 33:37
  Speaker 3: Oh God, i've thought about this since you asked the panel last year at Pelvicon.
• 33:40
  Speaker 3: There's a few things like I really have gotten into sewing since I went first went to Burning Man in 2010.
• 33:46
  Speaker 3: I learned how to sew.
• 33:47
  Speaker 1: Really.
• 33:48
  Speaker 3: And it's the most fun hobby, yeah.
• 33:50
  Speaker 3: So on my other, instagram is kind of where I post my creations.
• 33:54
  Speaker 3: It's usually kind of workout clothes.
• 33:56
  Speaker 3: It started off as costumes after Burning Man.
• 33:58
  Speaker 1: I guess that's where side stitch Jake comes from.
• 34:01
  Speaker 3: No, Yes, yes.
• 34:03
  Speaker 3: And that's the double entendre with.
• 34:05
  Speaker 3: You know I'm a runner by training.
• 34:06
  Speaker 3: You know by that was running was my identity through college and after, and so it's kind of the side stitch and stitching from sewing.
• 34:16
  Speaker 2: That was where my other Instagram keeps Nice, cool man of many talents.
• 34:22
  Speaker 2: Well, jake, thank you so much for being on.
• 34:24
  Speaker 2: Thank you so much for being talking at Pelvicon.
• 34:26
  Speaker 2: I know one of the things that you are excited about is the field progressing, but that's also one of the things that you are making happen.
• 34:33
  Speaker 2: I mean pushing that forward.
• 34:35
  Speaker 2: Thank you, we're really excited to bring that to Pelvicon.
• 34:37
  Speaker 2: We're really excited to continue to push that forward.
• 34:39
  Speaker 2: But thanks so much for being on.
• 34:41
  Speaker 2: We just really appreciate you.
• 34:42
  Speaker 3: Thanks for what you guys do.
• 34:43
  Speaker 3: I can't believe it was.
• 34:44
  Speaker 3: Do you say 300 episodes, roughly now, of this podcast?
• 34:48
  Speaker 1: Yeah, over 300 now.
• 34:49
  Speaker 1: It's pretty crazy.
• 34:51
  Speaker 3: That's a lot of work And that's it's really great what you guys are doing for the field too, so good to see you guys.
• 34:57
  Speaker 1: We're super excited to see you in September.
• 35:00
  Speaker 3: I can't wait.
• 35:00
  Speaker 3: I cannot wait for PelvicCon.
• 35:07
  Speaker 2: What a great conversation with Jake.
• 35:09
  Speaker 2: It was really eye-opening hearing what it was like for him being a male in Pelic Rehab And it was really great to hear that he started to see that shift.
• 35:19
  Speaker 2: Frankly, he's been a big part of that shift toward making that more inclusive, but it was really interesting hearing some of those early stories from his training.
• 35:28
  Speaker 1: Yeah, absolutely.
• 35:29
  Speaker 1: I hope you guys got a lot out of this podcast.
• 35:31
  Speaker 1: I am super stoked for you to hear more from Jake at PelvicCon this year.
• 35:37
  Speaker 1: We have chosen him for a reason His topics are really going to knock your socks off And I'm just really excited for you to gain a lot of the knowledge that he's going to be put now.
• 35:47
  Speaker 2: Absolutely So.
• 35:47
  Speaker 2: If you are going to PelvicCon we're going to be seeing in September, make sure first of all, that you've already got all of your logistics set and join us in taking over a hotel in Atlanta and just be getting excited.
• 36:00
  Speaker 2: Make sure you have your add-ons as well.
• 36:03
  Speaker 2: Whether that is the closeout celebration dinner, whether that is the post con with Jay and Amber, whether that's one of the clinicians lunch or the business owners lunch.
• 36:11
  Speaker 2: Make sure you're getting your tickets for those before those sell out.
• 36:15
  Speaker 2: And if you weren't able to join us this year, look into grabbing the recording.
• 36:21
  Speaker 2: You can hear both of Jake's talks on both anal sex and evaluation and treatment of erectile dysfunction, as well as what 12, 13 other ones that from all of our speakers who were all trailblazers in their own right.
• 36:34
  Speaker 2: It really highlights the full breadth of our field And right now it's going to be the lowest price you can get that recording for It's $50 off for that early bird special.
• 36:44
  Speaker 2: You can help the peviconcom to check that out and to order that.
• 36:49
  Speaker 2: That's PelvicConcom, so really excited for it.
• 36:53
  Speaker 2: I cannot wait to be seeing all of our PelvicCon speakers in person and not that much time, nicole.
• 36:58
  Speaker 1: Super awesome And even if you can't join us, you have the opportunity to learn from these amazing folks.
• 37:04
  Speaker 2: All right.
• 37:05
  Speaker 2: Well, as always, guys, let us know if you have any questions.
• 37:07
  Speaker 2: feel free to reach out to Jake If you have any questions from his conversation today, but, as always, let's keep this conversation going and let's continue to rise.