TEXT: Iva Hradilová, occupational therapist at the Paraple Center 

The differences between men and women are both physical and psychological - in the area of organs, hormones, but also in different life roles. There are things that a man can never experience and sometimes even understand. And of course the reverse is also true.  
A man is not able to carry a child under his heart for nine months (note: the only one who has done it so far was Arnold Schwarzenegger in the movie Junior , but that is a Hollywood exception). And even if he can stand in for his mother really well, he can never fully replace her. 

The female body is also equipped to withstand more pain and higher levels of stress. But this is often treacherous for him, because then it is difficult to know where the line is, when enough has to be said.  
Many books and many scientific studies have been devoted to the differences in male and female thinking. However, none of them is 100 percent, as there are men on one side and women on the other, and this always brings a subjective view of the matter. Now, more specifically, to what we have prepared for you. A stroller changes a lot in a woman's life and often makes quite ordinary things very special. That's why my colleagues and I decided to treat the "female" topic comprehensively and from many angles and prepared a series called WOMAN INTIMATE. 

As part of it, we will stop at different areas. We will show the variety of paths in specific phases of a woman's life. It is then up to each of you whether any of them (or even just a part of them) will be yours.  
The individual parts of the series are devoted to topics such as self-care, menstruation, pregnancy, childbirth and the postpartum period, and we will end our journey through the female world with the topic of menopause.  
The entire series is prepared for you by women – experts, mothers, wives, daughters, sisters... Women who like women, who understand women and who have enough life experience. The editorial team includes a psychologist, occupational therapist, physiotherapist, exercise therapist and nurse. We will also continuously invite other external collaborators, mainly from the ranks of doctors.  
And always several clients willing to share even very confidential things with everyone. A big thank you to them for that! 

It may seem to you that some information is repeated, only it is grasped from a slightly different point of view. However, this is only proof that they are important and that the individual authors perceive it as such. 

And even though in this series we will be dealing with mainly female topics and it is primarily intended for women, and even though it is linguistically related to them, this does not mean that it is forbidden for men to read. Maybe just the opposite. 

If some of the topics have already appealed to you and you would like to share your experience with us, then you can contact us at the e-mail address paraple@paraple.cz , please put Woman intimately in the subject line. Another option is to get in touch with the individual authors via the contacts listed below. Anonymity in public sharing is a matter of course if you wish for it. 

 Why do we start with self-care? 

At the very beginning, we all agreed that before we get bogged down in individual areas, it is important that everything starts with a look at yourself, your needs, self-perception, self-evaluation, etc. Given that we know where in a woman's life her SELF is mostly stands (and there is usually no front row), we have taken the liberty of placing it in first place. 

Stop with us and take care of your body, your mind and treat yourself to a moment just for yourself. 

 

SELF-CARE AS THE BASIS OF LIFE 

TEXT: Danuta Sliwková, psychologist at the Umbrella Center 

Self-care means taking care of the needs of your body and soul. The level of self-care depends on how much we value and invest in ourselves. It is closely related to self-worth and self-confidence. How much do I value myself? Do I trust my feelings? Do I perceive the signals that my body sends me, do I notice them at all, do I understand them? We often see that it is not. 

We women are very often led from an early age to take care of everyone else first and then maybe, somewhere far at the end, our own needs. 

From childhood, our parents and teachers lead us to believe that what we feel and need is not very important and we should not pay too much attention to it. Ensuring one's own needs is even often confused with ruthlessness. 

 

When the body tells us "NO" 

How much can we last? How many more times do we swallow something, grit our teeth and move on? Society pushes us to accomplish and do a lot, ideally more than anyone else. 

Here I will use a free quotation from the book of well-known psychiatrists, Radkin Honzák and Alena Večeřová-Procházková, Girls, sometimes don't take it easy . In it, the woman is immediately compared to a horse, a draft animal that can bear a lot. 

Sometimes we have to hit rock bottom in order to meet our limits and bounce back and allow change into our lives. We must understand that we cannot pour from an empty vessel. 

The journey to that imaginary bottom can lead through illness, injury, difficulties in relationships, loss of something really valuable, etc. 

However, no one should forget that the body is connected to the soul and vice versa. There is no separation, one mirrors the other. 

 

Emotions as a guide 

Emotions can be our guide in everyday life, in working on ourselves, if we give them space and learn to work with them. Sometimes they give us a hard time and hurt. That is why we often run away from them and prefer the path of reason. It is more comfortable and safer not to "feel". 

But in time we will find out that this path is not the right one. Chronically repressed emotions create stiffness in the body, which results in various types of pain, inflammation and disease. 

In the field of somatic psychology, we talk about "character armor" - this is a muscle block that prevents internal flow and is so strong that it can block even the largest joints, vertebrae, contract organs, etc. 

How someone walks, stands and sits paints a picture of how they will be psychologically. Our physical posture reflects our inner attitude and attitude towards life. 

 

Let's live more fully thanks to the resources 

Resources play a key role in self-care - we draw strength from them, they provide us with a sense of security, peace, make us happy and strengthen our personal boundaries. 

But they mean something completely different to everyone. Their search brings us back to ourselves - we have to notice what is good for us at the moment and what is not. Resources give birth to nice thoughts, we experience pleasant feelings with them and they are beneficial to our physical body.  
The source, that is, what helps us and gives us energy , can be, for example, a cup of our favorite tea, a view of a tree, a hug, time spent with someone we like, laughter, a walk in the park, a vacation, adequate exercise, watching a favorite movie , playing a musical instrument, petting a pet, etc. 

 

Let's be kind to each other 

Taking care of yourself with kindness and patience is key to feeling inner peace and balance. It shows the conditions in which we grew up - whether our home was imbued with safety and love. Then we can treat each other with respect, patience and understanding. 

There is also intergenerational transmission, which ensures that the lives of our parents, grandparents and other ancestors are imprinted on us, in both positive and negative ways. We want to change some worse family patterns during our lifetime , but we cannot do it. We then pass everything on to our children, who in turn somehow work with them. They will help them, hurt them, move them on. That's why every generation is a little different. Such is the evolution of mankind. 

 

 

SATISFACTION IN EVERYDAY LIFE 

TEXT: Sylvie Dundáčková, head of the movement section of the Paraple Center 

Don't have time for yourself and can't relax? Do you want to feel good and get to know yourself better? Do you need to work more effectively with emotions and everyday stress? Then the following text is intended for you. 

I feel like no one has ever taught us this in our lives. And that's why it's time for us to learn it ourselves. Fortunately, today society is quite open to this topic and people themselves are looking for ways to bring a pleasant balance into everyday life. 

I only realized with the arrival of my own family that if I don't start paying more attention to myself again, I will burn out. It wasn't far. 

Putting yourself first is not selfish at all. And it doesn't necessarily mean that you do something just for yourself for hours and hours a day. You can get started in just a few minutes. Even these seemingly short periods of time can bring big changes to life. 

It is important to admit that when we are satisfied and full of strength and feel good, then it will have a positive impact not only on us, but also on those around us. 

Below I will offer you several options for how to do it in everyday life. 

 

Don't be afraid of change or something new 

Our brain resists change, it likes to drive in autopilot mode, thus saving energy. And they also resist the courage to stand up for themselves with full force, because then that means doing things differently. Different than you originally saw them, different from what your surroundings expect from you, but often even yourself. 

 

Cultivate daily rituals 

Rituals have always been part of social and family life. And in different cultures around the world. The need for rituals is one of the basic human instincts - for a sense of belonging, continuity and meaning in our existence. Rituals are necessary to induce good psychological well-being and inner peace. 

We should all have some private little things during the day that we look forward to. A ritual can be anything that we experience with full awareness, repeatedly every day. 

Morning ritual 
Create a morning ritual to start your day on a positive note. It can be enjoying a coffee in peace, breathing exercises, meditation. It's about getting in tune with yourself briefly. 

Notes 
Writing down helps. Not only with organizing time, but also, for example, with prioritizing things that need to be done. Writing down your thoughts can also be good because you can look back over time, where you were mentally a month ago. Or you just sort out your thoughts. 

Inhale and exhale 
Breath is part of our life and guarantees us anchoring in peace. And it's free, too.

Here I will introduce two short and very effective techniques that can become your ritual. 
The first technique focuses on deepening calmness. If you need to adjust the seat to make it more comfortable, do it. Then pay attention to the breath and its flow. Breathe in to the count of four. Do not hold your breath and feel its depth and flow. An inhalation is followed by an exhalation during which you can count to six. Repeat everything at least five times, but definitely until you feel more relaxed. To enhance the effect, imagine inhaling peace and harmony and exhaling peace and relaxation. 
The second technique is good for processing stress and emotions. Begin to inhale slowly through your nose. The breath is deep and long. You feel your chest opening up. Exhale deeply and relaxedly through your mouth. Repeat the entire inhalation and exhalation process for one minute. 

Affirmation 
These are short empowering phrases that we intentionally repeat either out loud or only in our mind to influence our life for the better. 
Choose an affirmation that is relevant to you and repeat it to yourself whenever you need it during the day. In order for it to work and have a response, try to really tune into it internally, accept it as a part of yourself. 
For me personally, affirmations help a lot to strengthen my inner self and to better manage everyday obstacles. An example of such an affirmation can be: "I am willing to realize my awesomeness under all circumstances, in all situations and in front of all people." I have everything I need in me right now.” 

Joy and laughter 
Joy is a spontaneous internal emotional response to a pleasant event, person or memory. How often do you rejoice during the day? Or how often do you laugh? 
I had to purposefully start bringing reasons to be happy into my life, as well as relaxation and laughter. As if I forgot about it under the weight of " adulthood ". 
There are people who have the ability to enjoy themselves. They can take pleasure in little things. On the other side, there are people who see a problem in everything and do not allow themselves to experience the feeling of joy. 
Develop your sense of humor. Try to laugh at yourself too, try to find humor even in unpleasant situations, eliminate stress and try to be like children - they are the greatest experts on lightness of life, play and laughter. 

 

Feeling beautiful is really important 

Feeling beautiful is a pleasant emotion, but at the same time it is very variable, just like fear, joy or sadness. We cannot always influence how we perceive our appearance. Sometimes we have a good day and sometimes we don't even want to talk to each other. It is often related to the phase of the menstrual cycle, but more on that in the next part. 

Taking care of your body is not a whim, but a necessity and a matter of self-respect. However, remember that the environment does not perceive you as strictly as you do yourself. When someone gives you a compliment, accept it and say thank you for it. I have a feeling that we often don't do that very well either. 

Follow your own path of beauty, with kindness to your body, where no extremes or modifications are needed. 

I've tried on myself that if I make up and paint myself a little bit every day, I feel much better and I'm not afraid to look at myself in the mirror. 

Online courses 

They have their place not only in this topic, education is important. Today, courses focused on self-knowledge, satisfaction, finding inner peace or femininity are very popular. 

Their advantage is the possibility to learn new things from the comfort of home. Let new energy, thoughts, motivation and ideas into your world. 

How about these? 

Course Key to your inner peace (Lucie Kolaříková) 
The motto of the course: "In order to cope with it, whatever it is, and enjoy life, no matter what happens." 

Magically beautiful course (Michaela Měřínská) 
Motto of the course: " Beauty and conscious care for one's femininity, inner well-being and self-confidence begin in the head. Dive deeper and learn to let your beauty shine from within . " 

In conclusion , it is good to mention that with regular and conscious self-care, both on the physical level and on the level of the mind and soul, we will begin to value ourselves more. Allow yourself to be beautiful, present, but also imperfect and yourself. 

I hope this text inspires you to create a personal self-care plan and bring natural balance to your life. 

 

References 

KOLAŘIKOVA, Lucie. Textbook of Self-Love . [Czechia]: Women to Women®, [2015]. ISBN 978-80-260-7688-9. 

KUMAI, Candice. Kincugi for a Happy Life: A Japanese Art for Enhancing Mind, Body, and Spirit . Translated by Tereza GRUFÍKOVÁ. Prague: Euromedia Group, 2019. ISBN 978-80-7617-315-6. 

Links 

Magically feminine online course 

Online course The key to your inner peace 

 

HOW TO PLAN YOUR DAY OR PERSONAL TIME MANAGEMENT 

TEXT: Iva Hradilová, occupational therapist at the Paraple Center 

 One of the main tasks of us occupational therapists is to lead a person to the highest possible degree of self-sufficiency and independence. And we don't just deal with it by individual activities, but with a comprehensive view. Our goal is to find a balance in the degree of self-sufficiency, independence and assistance so that you, the clients, in this case women in wheelchairs, can live a full, active life for as long as possible. 

We are very well aware of how demanding and sometimes burdensome it is for the body of a wheelchair user to carry out normal daily activities. At the same time, however, we know that it can also be beneficial for maintaining a good condition. 

So how to plan your time effectively and balanced? Perhaps the following few points will help you. 

1. Follow the same routine most days of the week. This means when you get up, eat, work, rest or go to sleep.
2. Get a diary or a larger calendar, or keep it in electronic form if that's closer to you.
3. Think about your entire week. What do you need to accomplish and when do you need to do it?
4. Also plan activities beyond your normal day that you know about in advance. If these are activities that can be broken down into smaller tasks, do so.
5. Check off completed tasks - it can make you feel good, and you also know what's still waiting for you.
6. If you expect more demanding duties in one day, get help with your daily activities.
7. Leave things that you don't have to do to other household members. If you live alone, contact an assistant.
8. Be active in your free time in a way that suits you so that you feel good. Don't forget to rest, for example during a walk, sports or coffee.
9. Try to think about yourself and during the day stop and stretch or just take a moment for yourself.
10. Keep some free space every day as a reserve "for Uncle Příhoda".
11. If possible, use tools in your life that will make it easier for you. Occupational therapists will help you find and learn to use them. 

For example: If you are active during the day and still want to go for a walk or a trip in the afternoon, don't be shy about using an additional electric drive for your wheelchair or handbike . 

1. Remember that there are very few things that cannot be put off until tomorrow, and cleaning is definitely not one of them.
2. Don't hesitate to ask for help, there's no shame in it! 

 

"WOMEN'S THINGS" AFTER SPIN INJURY AND THE IMPORTANCE OF PREVENTION 

TEXT: Petra Hladíková, general sister of the Paraple Center 

The good news is that a spinal cord lesion in women does not fundamentally affect their reproductive capacity. The menstrual cycle, which is interrupted immediately after the spinal cord injury, returns after three to six months. A woman after a spinal cord injury is reproductively healthy, but other barriers, often associated with neurological deficits, physical or psychosocial, can also lead to problems with pregnancy. 

Neurological physical deficits include mobility impairment, spasticity or incontinence, which fundamentally affect sexual behavior. The neurological psychosocial deficit is then influenced by the fact that we women are more prone to emotional and psychological disorders. 

The willingness and motivation to engage in sexual activities again is conditioned by age, the quality of the relationship, social integration, but also the extent of the information obtained. 

It is equally important that we actively take care of our health and do not forget about preventive examinations, regardless of whether we want to continue to be sexually active or are planning a pregnancy. 

 

System of gynecological prevention 

The system of gynecological prevention is no different for women after spinal cord injury. However, if you are a woman in a wheelchair, then when choosing a gynecologist, you should think about the fact that he has experience with the target group. Such gynecologists are more often found in teaching hospitals, which also include spinal units, and the doctor can thus contact colleagues from the spinal unit more easily, if necessary. 

You should also be interested in whether the chosen practice has barrier-free access and the environment (door width, WC...) as well as the practice's equipment. It should be equipped with a height-adjustable, positionable and non-slip gynecological chair. 

Before each examination, it is also advisable to arrange with your gynecologist in advance medication to affect spasticity, which can greatly complicate the gynecological examination. 

In connection with the preparation of this series, we teamed up with the Vozejkmap project and requested the mapping of barrier-free gynecological surgeries. 

You can help too. If you know of a doctor's office with barrier-free access and equipment, and even better with staff willing to help with the transfer, please record it on www.vozejkmap.cz or in the Vozejkmap mobile application. 

Preventive gynecological examination 

From the age of fifteen, every woman is entitled to a free preventive examination by a gynecologist once a year (after eleven months). The screening is tailored to the woman's age and whether she is sexually active. 

During the preventive examination, the doctor first processes the personal and family history, especially with regard to risk factors. 

The genital examination itself can be supplemented with an ultrasound examination. The doctor should also examine the skin and palpate the lymph nodes in the genital area. 

A preventive examination should also include instruction on breast self-examination. For women aged 25 and over, the doctor will also perform a clinical breast examination if there is a family history of breast cancer or other risk factors. 

If you have a sensitivity and grip disorder, then your gynecologist should perform a breast examination at every preventive examination, regardless of age, or send you for an ultrasound examination. 

Cervical cancer screening is also performed during the preventive examination. The doctor takes a sample of tissue from the cervix and sends it to the laboratory for cytological examination. 

The gynecologist should also take care of other screening examinations of the woman for the prevention of cancer. It should provide recommendations for mammography (from 45 years old once every 2 years, if possible at the same accredited workplace) and provide screening for colon and rectal cancer (detection of occult bleeding in the stool by a special test once a year from the age of 50 and once after 2 years from the age of 55, or screening colonoscopy once every 10 years). However, a general practitioner can perform the same examination for women, or give them a recommendation for it. In that case (if the results are available), the gynecologist will no longer prescribe them. 

 

Do not forget about self-examination 

The simplest method of early detection of breast cancer is self-examination. As the name suggests, we do it ourselves, regularly once a month. 

However, if you are just starting out with self-examination, then you should do it every day for a month. This is the only way you will learn to know the geography of your own breasts. 

The best time for self-examination is the second or third day after the end of menstruation, when the breasts are free of tension. For those of you who don't menstruate, any easy-to-remember day is fine. 

Do the self-examination after showering with warm water, when the skin is relaxed and supple. 

Here's how to do it: 

1. Undress to half your body and stand in front of the mirror. Grasp your armpits freely with both hands and, under sufficient lighting, find out if you notice changes in the shape of your breasts and their surroundings or if there are lumps somewhere, the skin is not wrinkled, or if any of the nipples are pulled inward. If you don't have both breasts the same size, there is no need to worry - this is a completely natural phenomenon. 

2. Pick up both hands and continue the previous observation by turning slowly from right to left and from left to right in front of the mirror. 

3. Grasp the breasts one at a time with your palms and feel them first in a horizontal and then a vertical sliding motion. Observe whether you feel a hardened spot or a lump. 

4. Lower your left arm down, use your right hand to feel around the left nipple in the middle of the areola, then gently squeeze it for milky or bloody discharge. Examine your right breast in the same way. 

5. Lie on your back, support your head with a small pillow and place a folded towel under your left shoulder blade so that your breast is in an elevated position. With your right hand, feel your breast and its surroundings. Examine your right breast in the same way. 

6. Feel your left breast with gentle pressure on the inside of your three middle fingers (not their tips). Start from the outside, from the bottom, in circular motions around, always closer to the center of the nipple. Do this twice. One hand is placed under the head and the other hand is loosely attached. Follow the same procedure when palpating the right breast. 

7. Put your left hand under your head and with your right hand feel (with similar movements as in the previous case) your armpit to see if there is a lump in it. Examine your right armpit in the same way. 

8. Hold loosely with your left hand. With your right hand, feel the fossa above the collarbone. Examine the right side in the same way. 

Don't miss any location. Some changes can be discovered in their beginnings in just one of them. For any finding or just doubt, see your doctor. A change found does not necessarily mean that you are sick, but you need to be sure. 

Self-examination is a very important habit and for many women it has already saved not only their breasts, but also their lives. It should thus be a completely normal part of the personal hygiene of every modern woman. 

Images for self-examination can be downloaded at https://www.zdravaprsa.cz/zdrava-prsa/samovysetreni/ . 

Symptoms of breast disease 

The most common symptom of the disease is a painless swelling or lump with irregular edges anywhere in the breast. Other symptoms may include redness, an orange-peel appearance, dimpling, swelling of the skin, oozing, non-healing sores, indentation or discharge from the nipple. A lump in the armpit or groin also points to cancer. 

"LOOK AT YOURSELF, HOW ARE YOU STANDING?!" OR TAKE CARE OF YOUR BODY 

TEXT: Hana Vatěrová, physiotherapist at the Paraple Center 

 That's what my mother often told me. And she was very right. A lot can be determined from a person's attitude. We physiotherapists know a little more. And it can be determined even from a sitting position. And from sitting in a wheelchair, I'm like a scumbag. 

  

What exactly is a pan? 

From the point of view of load, the pelvis forms a kind of converter between the trunk and the lower limbs. It is a solid structure that is affected by forces, pressures and pulls, and therefore it is strengthened by ligaments, which at the same time must enable movements transmitted from the lower limbs or the trunk. 

On its lower side, in the area of the small pelvis, it ends with a significant muscle. It is the so-called pelvic floor. 

The pelvic floor has a bowl-shaped shape and is composed of a total of three layers. We all probably know the superficial layer, they are primarily the sphincters. However, each of the layers has a significant function. 

The pelvic floor muscle not only passively supports the internal organs, but also engages with its antigravity muscle function, and even regulates the pressure in the torso. In addition, it affects also the sexual and excretory function. 

But the pelvic floor area is not just muscles. It is also a system of ligaments, which has the task of holding bone structures together, but at the same time allowing them to move gently, while others hold internal organs in place. Today, however, we also know that even internal organs should have their own natural movement, i.e. a defined space for it , and therefore that other soft tissues should also adapt to this and vice versa. Proper positioning and storage of internal organs supports their natural function. 

How about evolution? 
The pelvic floor is closely related, for example, to the abdominal muscles. In ancient times, when man began to walk upright, the originally abdominal wall had to slowly transform into the abdominal floor. What used to point backwards suddenly points down. The weight of the internal organs was then taken over by the pelvic floor, which had to start cooperating more with straightening the torso and with the main respiratory muscle – the diaphragm. 

A "correct" pelvic floor should also adequately cooperate with other so-called functional closures in the body as a whole. In yoga, the so-called bandhas (in the diaphragm, in the throat, etc.) could be a certain analogy to these functional closures 

Pelvic "problems" 

Secretion 

Clients with a spinal cord lesion may suffer from constipation, which in the chronic phase can affect the disorder and position of the small pelvis. Therefore, prevention and regular elimination are important. We can also apply the visceral therapy mentioned below. 

Urinary sphincters can also be damaged in the sense of incontinence or, conversely, arrest due to spasticity. We always choose the path of perfect emptying, which is why the most suitable way is gentle tubing. 

Sexual and reproductive function 

After a spinal cord injury, clients often have an intact ability to have sexual intercourse and also the ability to get pregnant. However, individual sexual disorders appear, such as a reduced ability to lubricate and orgasm. Therefore, be careful of vaginal injuries during sexual intercourse. 

After vaginal births, usually only soft tissue disorders occur, which are well treated per vaginam , possibly. per rectum , even at longer intervals. 

Major surgical interventions in the abdominal area are then subject to more extensive care. In general, however, deep abdominal pressure is not recommended, especially in the case of loosening of the fibrous apparatus, shortly after operations, in case of non-functional muscles and also in the obese. 

Prevention is key 

Regular gynecological check-ups will prevent complications such as inflammation, adhesions, fibroids, endometriosis, descent and loosening of internal organs. 

  

Pelvis from the practical perspective of a physiotherapist 

In practice, we notice the position of the pelvis, trunk and lower limbs, their movements and muscle interplay. We observe fine details around the pelvis, pubic bone, coccyx, muscle and ligament tension and painful sensations. We often find the pelvic floor in our clients to be dysfunctional, but it can also be overloaded. Next, we examine the condition of the other soft tissues deep in the pelvis. 

In people in wheelchairs, the deviations found in the pelvic floor can be closely related, for example, to worsening spasticity. Of course, their relationship can also be the opposite - spasticity of the lower limbs or trunk affects the pelvis area. That's why we so often try to eliminate spasticity not only of the lower limbs and trunk with passive movements and stretching. 

  

Pelvic floor therapy 

In the therapies of this area, you will probably encounter a combination of several techniques (including techniques for relaxing the spine, mobilizing the ribs, with visceral techniques, there are also techniques for relaxing the suspension system of the small pelvis, for example). 

Not only the gentle contraction of the pelvic floor muscles is practiced, but also their subsequent relaxation. All this in context - with the involvement of the entire torso and with the correct breathing pattern. Soft tissue relaxation therapy is often an integral part here , e.g. lymphatic massages are also suitable. 

There are therefore more therapeutic techniques and approaches. The one most focused on the pelvic floor is probably the still developing method according to Ludmila Mojžíšová . However, techniques for becoming aware of the deep muscles in the small pelvis are also suitable for supplementation. The Alexander or Feldenkreis technique can help us improve the perception of the whole body and the small pelvis. 

And let's not forget yoga. Today's well-known hormonal yoga therapy is also aimed at improving the position of the pelvis, the function of internal organs, and adjusting hormone levels and energy flows in the body. And since the individual types of yoga are very intertwined, from a physiotherapist's point of view, e.g. spiral yoga also seems suitable. 

In the field of gynecology, the cantienica technique , which initially based on the method spiral dynamics. Again, the emphasis is more on relaxed movement and improving the posture of the entire pelvic area. 

Isolated strengthening of the pelvic floor muscles is rather abandoned these days. 

You know that… 

... the pelvis is not only examined from the outside, but that it is also possible to examine it through the anus or vagina? The information from this examination can greatly help us influence the state of pain, muscles and the fibrous apparatus of the pelvic floor. Sometimes we cannot do without this examination and therapy. So overcome fear and shame, it matters! 

Beware of autonomic dysreflexia 

A dangerous reaction of the body that can only occur in the case of damage to the spinal cord from the Th6 vertebra above, related to the pelvic area. It is often caused by irritation from the abdominal cavity or any pain or other irritating sensation that occurred below the level of the spinal cord injury .  

Therefore, we should take autonomic dysreflexia into account especially where there is any sensitivity disorder, but also during the examination that is in direct contact with the sensitive pelvic floor and sphincters. 

  

Therapeutic interests 

Ludmila Mojžíšová, who was already mentioned, noticed the influence of position and movement in the area of the pelvis most significantly, who was also the first to research their effect on the activity of internal organs. In connection with the examination of the pelvic area, she devoted herself to observing the client's movement, connecting the found blockages of the spine and ribs with blockages and overloading in the pelvic area, and examined pathological muscle chains. She thereby revealed errors in the position and movement of the pelvis, sacrum and coccyx and was able to attribute to them an influence on the activity of the pelvic organs. 

In physiotherapy today, we know that every internal organ with its impaired function will manifest itself, for example, on the surface of the body. Irritation from the inside causes manifestations of disturbances in the adjacent area. These irritations can then be manifested, for example, by changes in the mobility and posture of the joints, reflex changes on the skin, and irritating points on the body. So-called visceral therapy is devoted to the remedy (supporting the activity of an internal organ). 

  

Put yourself in the hands of an expert 

Sometimes it may seem to you that your body controls the activity of the pelvic floor muscles well , however, the objective finding may differ. Conversely, where we do not feel any overload, it is possible to find defensive or pathological signs phenomena from overload or hidden pain. 

And it's the same with exercise. It may happen that with imperfect training of the function of the pelvic muscles, you will unnecessarily overload these or other soft tissues. 

It all comes down to perfect, subtle collaboration. 

  

Recommendations for maintaining good condition of the pelvic floor  

• Feel the changes and signals of your body, 
• symmetry is ideal - try to keep e.g. your shoulders, knees or pelvis at the same level, occasionally check yourself in front of the mirror 
• always keep in moderate physical condition, 
• don't forget about relaxation and time for yourself, 
• less is often more, even when exercising. 

 

In conclusion 

Arc back to the beginning. If you ask me how I'm doing today, I won't lie when I say, "I'm trying." 

  

References 

Havlíčková, M .: Physiotherapy for pelvic floor dysfunction, Art of Physiotherapy, 3/February 2017. 

Kolar, P. : Rehabilitation in clinical practice, Galén, 2012. 

Kriz, J., et al. : Spinal cord injury, Galén, 2019. 

Marek, J., et al. : Coccyx and Pelvic Floor Syndrome, Triton, 2000. 

Sedláková, S. : The back that exercises does not hurt, Vyšehrad, 2008. 

Strusková, O.  : Novotná, J., Method of Ludmila Mojžíšová, XYZ, 2007. 

Quiet, M. : Functional diagnosis of the musculoskeletal system, Triton, 2000. 

Vele, F. : Kinesiology, Triton, 2006. 

 

NATURE – MAN'S BEST FRIEND 

TEXT: Petra Hloušková, general nurse of the Paraple Center and Iva Leszkowová, external general nurse of the Paraple Center 

 In this part of our series, we would like to introduce you to general information about the use of plants in the field of self-care, as well as touch on the most basic interaction with herbs - aromatherapy. 

We will get to a more detailed presentation of plants or recipes for specific problems in future editions. 

 

We live in a busy time. Many of us do not have enough time for ourselves. We barely manage to sleep, eat, take care of basic things, and we simply forget about the other needs of our body. Such a lifestyle can easily lead to health problems, with which our body tries to call us back to itself. A frequent result of a stressful lifestyle is, for example, a hormonal imbalance, which is often the basis of other, not only gynecological, problems. In women, this fact is even more noticeable, as we are generally more sensitive and perceptive individuals. 

That's why we believe that slowing down the daily murderous pace and being well is very important. 

 

Harmonize your body and mind 

And nature will serve us best for that. Just being outside in a nice place can do wonders. It oxygenates the organism, causes the release of endorphins, stimulates the metabolism and much more. 

A number of these effects are proven not only by centuries of practice, but also scientifically. For example, that a slow walk in the forest reduces stress has been verified by measuring the level of the stress hormone cortisol. It also balances blood pressure, harmonizes the mind and leads to relaxation. 

The forest has a beneficial effect on all our senses. The rustling of leaves or the hum of trees in the wind will guide us to the alpha level that the body reaches during meditation. Visually, the green color of the trees, mosses and the arrangement of the forest will calm us down. And last but not least, our sense of smell is affected by the essential oils released from the trees. Essential oils from coniferous trees have an antiseptic effect, have a beneficial effect on the respiratory system, support immunity, calm the mind and induce relaxation. 

That's why we recommend spending at least an hour a day in nature and making walks a daily ritual. 

 

Aromatherapy 

Herbs are a piece of nature that can help you even in the comfort of your home. The easiest way to start with them is in the form of the aforementioned aromatherapy, using so-called essential oils. These are often also commercially referred to as essential oils, essential oils or essences. 

They are obtained by distilling various parts of plants and are very volatile substances. They contain small molecules that easily penetrate into the respiratory tract or through the skin and into the blood, where they perform their functions. 

Our olfactory center is connected to the limbic system in the brain, which is the control center for emotions. Thanks to this, essential oils have a positive effect on our psyche. 

It was found that the home application of essential oils from conifers has a similar effect as when staying in the forest, only it is shorter. Essences from conifers, such as pine or fir, strengthen the immune system, improve breathing, facilitate coughing and can take us right to a forest path in the mind. 

Aromatherapy can be practiced in the form of inhalation, bath or massage. You just need to study the properties of a particular essential oil in advance. 

And then there is a simple rule - if it doesn't smell good to you, get rid of it. Trust your body. 

ATTENTION - not all essential oils can be applied undiluted to the skin. 

The most used essential oil is that of lavender. It acts against stress, induces relaxation and sleep, relieves headaches or even menstrual pains. 

 Drink, bathe, lubricate… 

Other ways to use herbs are infusions/teas, decoctions, macerates, tinctures, syrups, pills, salves, poultices, and more. 

infusion/tea by pouring hot water over selected herbs (or their mixture) and then steeping for a short time (usually 10 minutes) under the lid. 

decoction from cold water, into which you put the herbs and quickly heat everything up to a boil. Then you cook on a low heat for usually 10 minutes and then let it stand for 15 minutes in a covered container and drain. 

macerate by pouring cold water over the herbs and letting everything stand for the necessary time. Then drain. 

A tincture is a solution created by steeping herbs in alcohol. Compared to other procedures, the use of tinctures has several indisputable advantages. Thanks to the infusion in strong alcohol, they contain a high concentration of active substances, are easy to use, dose and store and last a long time. 

All teas, decoctions and macerates should be prepared fresh for each use. 

It's not a drug like a drug 

In connection with herbs and recipes for their use, you can often come across the term drug . In this case, however, it is not an addictive substance. This term means that it is about preserved (most often by drying) plants, either whole or their parts, or animals. 

The term drug is derived from the Dutch word droog = dry. 

Principles of using herbs 

Although they come from nature, they can sometimes be dangerous. The first danger is plant confusion, in the worst case, confusion with a poisonous plant. Therefore, if you are not sure of your recognition abilities, it is better to get or buy them from verified sources. 

Furthermore, the quality of plants or finished products is also very important. Collected plants must be of good quality and from good habitats and must not contain mold, otherwise they can be harmful. For the same reason, we must also take care of their proper storage. 

Herbs contain a lot of active substances, so they should not be used without thinking. It goes without saying that the prescribed amount and the correct method of use are observed. 

And a little advice - herbs do not affect every organism in the same way. So if the first option doesn't work for you, it's definitely worth trying another, similarly effective herb. Only here in the Czech Republic there is so much to choose from. 

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TO PHYSICS 

Life doesn't end. Everything begins. Different and more joyful (HL, 65 years old) 

For me, it's mainly about being happy with myself. A little pampering. Not only on the outside, but trying to be a beautiful woman who has a balanced body and soul. 

After an accident and three operations, I was born a second time. Fortunately, I accepted it without resistance or regret, even though paralyzed from the waist down. I can continue to enjoy life to the fullest. Although he has absolutely changed, in everything. The new situation is a challenge both physically and spiritually. I take care of myself with great patience. 

Once, after a very long time in the hospital, I had a dream and it ended with erotica. And that's when the doctor woke me up - a neurologist, a nice guy, the youngest primary care officer in the hospital. He tested the body again and asked the familiar questions. I confessed my dream to him. "Mr. Headmaster, I'm a big girl, so I'll tell you frankly, you just woke me up from orgasm. So nothing again.” We both laughed. Mr. Primary replied in Huron that there are three important functions of the body - peeing, pooping and making love, and that if it works every day, then it will be fine. 

I took it to heart and started taking care of myself in such a way that I felt balanced, satisfied and happy in all aspects. Healthy body healthy mind. So for me, taking care means returning to my hobbies, finding new ones and also moving further in the development of myself. 

My path to developing self-care led through the pelvic floor. I was in such severe pain after the accident that it was unbearable. Touching my clitoris during vasectomy caused pain and spasms in my pelvic floor that continued down my feet until my toes curled. So how am I going to coil? What about making love with a partner? 

I started searching, trying, I deepened the ways of working with the body, but also on a psychological level. 

I understand that this is a sensitive topic and taboo for many. That is why I dare to share this intimate area as well. 

I started looking for new solutions and help from a neurologist, a sexologist and physiotherapists. It wasn't enough, it wasn't it, it was still painful. 

After some time, I got to the physiotherapist Michaela Havlíčková, who examined me digitally and discovered that I had stiff strings in the entire pelvic floor. She showed me his anatomy in detail and the troubleshooting began. 

So it was worth it, sometimes the pain brought tears to my eyes. We also worked with breathing, and I was given tasks to do at home - in the shower or in bed, to practice contractions of the pelvic floor with a finger in the anus and in the vagina. She taught me intimate self-massage of individual pelvic floor muscles. After the first therapies, I finally experienced a feeling where nothing hurt when I was in contact with my genitals. It was a geyser of endorphins! Two years of clitoral pain were gone. However, it is important to exercise daily, otherwise the spasms and strings return. 

I also realized how important conscious work with the breath is and how great its effects are on the body and psyche. 

I ran into another problem - because of the titanium rods in my spine, I was no longer as flexible, so I couldn't reach "down there". So it was my partner's turn. The problem turned into an advantage - we started to communicate more openly. Our relationship deepened because of this, we talked, explained and listened more. We found out that the pelvic floor can be treated in other ways - by love, tenderness, sensitivity. My partner beamed and said, “Regular intercourse with a woman is the basis of good manners. After all, we can't live immorally." 

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TO THE PSYCHE 

I now understand what is happening to me and why (HL, 65 years old) 

An important part of self-care for me is working with the soul - psyche. 

After the accident, I started suffering from post-traumatic stress syndrome. Fears of various kinds appeared, restlessness, reluctance to leave the apartment, and it gradually resulted in panic attacks. 

Guided relaxation and meditation helped me a lot in Parapleta, but it wasn't enough. Stress, an argument, change came and I completely collapsed. Everything escalated last summer, when I was completely devastated after a meeting with the doctor. I couldn't do anything, I couldn't concentrate on anything, there were severe chest pains, a dull feeling in my head, I couldn't catch my breath, my heart rate was fast and I thought I was having a heart attack. I was terrified! 

And that forced me to start working with myself in another way - through psychotherapy. I asked for help from Danuta Sliwková , a psychologist from the Umbrella Center, whom I already knew and we met occasionally. 

First, there was a crisis intervention over the phone, then due to the covid-19 disease, we combined face-to-face and online meetings. We gradually worked on getting me to calm down. Relief came, pressures, fear disappeared and I began to listen more to my emotions and the physical manifestations associated with them. Although the panic attacks recurred several more times, each subsequent wave was weaker and I felt that I had control over them. 

Breathing exercises were of great importance here. I was relieved when Danuta explained to me that I was not crazy and I understood what was happening to me and why. Active work with my resources has become crucial, and I actually continue to do so. It all forced me to perceive myself more, to recognize the signals that my body gives me, to estimate the level of stress, to take care of myself with even more love, sensitivity and patience. 

I am comfortable with the psychosomatic approach, thanks to which I realized that what the mind suppresses and overcomes with coercion, the body remembers and returns to us with interest over time. And one fine day, he just can't bear the weight anymore. 

We continue with Danuta. I am learning to work with stress and resources, express emotions, relax, meditate and so on. 

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TO SATISFACTION IN EVERYDAY LIFE 

I never believed in myself very much (LG, 45 years old) 

I always felt so much worse than anyone else. Even as a child I was afraid of talking to people or in front of people, many ordinary activities stressed and limited me. You don't live very well with a lack of self-confidence. It complicates every day. 

Life went on, I finished primary and then high school nursing school and started working. I was most attracted to the ARO department, but I didn't have the courage. So I worked for many years in other departments. It wasn't until I was thirty-three years old that I managed to move to my dream department, which is still a matter of my heart to this day. 

I think that a nurse at ARO should have self-confidence. It didn't magically come out of nowhere for me, and yet I managed it quite well. I have always put enormous energy and love into my work, almost too much. Perhaps it can be seen from this that if a person really wants something, he can do it despite various limitations. 

At that time I already had four children. Life was running fast, it was a carousel of work, childcare, household, etc. There was no room for me at all. 

Maybe I had to come this far and sit in a wheelchair to realize that I really need to do something about myself. And that's what I'm trying to do now. I may be forty-five years old and look at the world from a wheelchair, but it's never too late. 

Only recently did it start to dawn on me that sometimes I need to take care of myself too - to give myself some joy. I go to work less and spend more time at home. I also recently went to a make-up artist - maybe it's a little vanity, but I wanted to see if she could turn me into something to look at. Yes, I still think I'm "something ugly and incompetent". But luckily it's starting to change, I'm starting to feel and think a little differently. Sometimes I just go for a walk to think for myself. It will probably take me a long time, but I hope I can make another shift.