Evelyn's Story*
Step 1
Evelyn discovered what mattered
Evelyn (she/her) is a 54-year-old high school English teacher and avid gardener who had been living with worsening diverticulitis for three years. After her third serious flare-up in 18 months, her colorectal specialist recommended bowel resection surgery. Evelyn was terrified - not just of surgery, but of what her life would look like afterward. During flare-ups, she experienced severe abdominal pain, bowel urgency, and sometimes accidents. She'd stopped going to staff meetings, avoided dinner parties, and had given up teaching her favourite literature elective. She was exhausted from constant vigilance around toilet access and convinced surgery would worsen her situation after reading online horror stories. Working together, we discovered that Evelyn's pelvic floor muscles were weak with poor coordination. Her bowel diary revealed urgency 4-5 times daily with passive faecal incontinence happening regularly without her awareness.
Evelyn's Pelvic Health Goals:
- Understand exactly what will happen after surgery so I can prepare myself.
- Know I'm doing everything possible to have the best possible outcome.
- I'm terrified the surgery will make things worse – I don’t want to have ongoing bowel accidents.
- Be able to teach my classes without worrying about bowel urgency or accidents.
- Go to social events and dinner parties and return to garden club meetings
- Travel to visit my daughter in Sydney without anxiety about toilets
- Feel confident leaving my house without constantly planning around bathrooms
Step 2
Evelyn restored what mattered
Pre-Surgery: Understanding that surgery would likely improve, not worsen, her bowel control was transformative. We started pelvic floor and abdominal muscle training, focusing on building strength and learning to use these muscles for urge suppression. Education about surgery, post-operative care, and realistic recovery timelines reduced her fear. Breathing exercises and relaxation techniques helped manage anxiety that was amplifying her urgency.
Post-Surgery: Six weeks after surgery, Evelyn was experiencing bowel frequency (4-6 times daily), some urgency and occasional smearing. We modified her pelvic floor program focusing on strength, endurance and timing. Bowel retraining strategies helped establish better habits and reduce frequency. Education about bowel emptying techniques ensured complete emptying. We worked with her gastroenterologist on diet to optimise her stool consistency. Hands-on treatment addressed abdominal tension and surgical adhesions.
Step 3
Evelyn enjoyed what mattered
After 5 months, Evelyn's bowel frequency had reduced to 1-2 times daily, passive incontinence had completely resolved, and her diverticulitis was gone. She returned to teaching her beloved literature elective and taking students on theatre field trips without anxiety. Six months after surgery, she visited her daughter in Sydney and was able to sit through a 3-hour performance without a single worry about her bowels. A year later, Evelyn commented "I can't believe I almost cancelled the surgery. My life is better now than it's been in years. No more flare-ups, no more accidents!"