Thursday, May 8, 2008

Kegel exercises: case

Case

A woman in her fifties is referred to me by her GP. She would like some information on kegel exercises in French.

Resolution

I do a search in CiSMeF and find the following resources:

Quand faire l'amour est douloureux- le vaginism (also available in English)
From the Society of Obstetricians and Gynaecologists of Canada (SOGC). This document explains how to do the excercises.

A few other resources are listed (on menopause, vaginal dryness, incontinence) but none of them provide much information on the topic, so I do a search in Passeportsante as well and find the following:

Incontinence urinaire. This document provides another explanation of how to do the exercises.

Hoping to find something accompanied by illustrations I also do a Google search (keywords exercises kegel) and find the following:

Excercises de kegel(pdf, also available in English)) . From the Women and Child Program Team at St.Boniface General Hospital which is a Catholic tertiary health care facility in Winnipeg affiliated with the University of Manitoba. This pamphlet provides a much more detailed explanation of how to do the excercises and includes an illustration of the pelvic region.

I print out each of these documents and give them to the patient.

Discussion


I find myself wondering how necessary it really is to keep looking for more information when the question has already been answered. What often ends up happening is that you find the same information repeated. In this case I was eventually able to find an illustration, and more detailed instructions so it seems that continuing the search was worthwhile. But what if that were not the case? What if I found the exact same information three times over?

I think the answer to the question is that it's always a good idea to keep looking even after the question has been answered. There are several reasons for this:
  1. Once several documents have been found that provide the same information, this confirms that you have fully answered the question.
  2. Sometimes the initial question has been answered, but additional information comes to light with a more extensive search suggesting that the topic is more complex than initially believed.
  3. Things like layout, print size and reading level can make a difference to the person reading the information.
  4. Repetition helps with the absorption of information.
Can anyone think of more reasons to keep looking? Can anyone think of reasons not to keep looking?





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