- Nicole Cozean, PT, DPT, WCS
Nutrition for Pelvic Health, An Interview (Part 1 of 3)
Dr. Laura Ricci is one of the country's foremost experts in nutrition for pelvic health. She also has an incredibly inspiring personal story, and understands better than anyone the importance that nutrition can play in dealing with serious health issues. She is based in Amarillo, Texas, but advises patients around the country and across the globe. We often talk about the importance of a holistic approach to healing - Laura has personified that in her own healing journey, and now helps patients add the nutritional component to their own journey. We're excited to have her for this three-part interview; for more information, you can visit Laura's website at lauraricci.vpweb.com.
Nicole: Hey Laura, thanks for bringing your expertise to PelvicSanity. For our readers, can you give a little about your background, how you began to specialize in nutrition for pelvic pain conditions, and what you’re currently doing in the field?
Dr. Laura: My pleasure! Thanks so much for allowing me to participate on your amazing blog! My background is actually in physical therapy. I have a doctorate in physical therapy, and I specialized in women’s health and pelvic floor rehabilitation. To be honest, I never dreamed I would specialize in nutrition or health coaching. I actually became a women’s health and functional nutrition coach through my own health challenges.
I had a long history of pelvic pain since I was 14 and first tried to use tampons. I was later diagnosed with provoked neuro proliferative vestibulodynia, and after several failed attempts with different medications, hormonal creams, and pelvic floor physical therapy, had two vestibulectomies (a partial in San Antonio, TX, in 2009, and a complete done in San Diego, CA, in 2010). After the complete vestibulectomy, I could wear tampons for the first time without pain, which was a huge victory for me, but was still unable to tolerate intercourse.
In 2011, I was diagnosed with an extremely rare sarcoma, called a desmoid tumor or aggressive fibromatosis, in my left rectus abdominis muscle (the six pack muscle). I underwent 4 surgeries, 1 for tumor excision, and the rest related to hernia complications from the synthetic mesh that was used to rebuild my abdominal wall after the tumor was removed. The last surgery for my abdomen was in 2013 and required a complete reconstruction of my abdominal wall, in which all the synthetic mesh was removed and the fascia of my external obliques was released to close a 12 cm ventral hernia using my own abdominal muscle. This was a really large surgery. I was in the hospital for five days, unable to bend over or lift over 5 lbs for 3 months post-op, and told I could not work as a physical therapist for a year, since I had two previous hernias and needed to take things easy to allow my body to heal.
It was during this time I found my own health coach, Jessica Drummond with the Integrative Women’s Health Institute, and started working with her to change my diet. I noticed several improvements after 3 months on an elimination diet: my chronic constipation went away, my face cleared up, left knee pain that I had for several months and tried to rehab myself from went completely away, and my PMS and menstrual cramps went away! I decided I had to learn more about nutrition and inflammation and took Jessica’s one-year certification in women’s health and functional nutrition coaching, and am now taking a two-year nutritional endocrinology practitioner training program through the Institute of Nutritional Endocrinology.
In 2014, I started developing hip pain. After seeing different orthopedic specialists and getting several types of imaging done on my hips, it was determined I had bilateral hip labral tears and bilateral impingement (both CAM and PINCER), due to bilateral adult hip dysplasia. Hip dysplasia is a congenital issue in which the hip sockets don’t form correctly from birth. It also made sense to me that these hip pathologies could be contributing to my lingering pelvic pain issues, even after a complete vestibulectomy. I was given the choice to do nothing and my hips would eventually wear out and I would need total hip replacement within 10 years, or I could do a young adult hip preservation surgery called a periacetabular osteotomy (PAO for short), where they fracture your pelvis in four places, separate the socket (acetabulum) from the pelvis, reposition it to give the hip joint better coverage, and place four large screws in the pelvis to hold everything in place while the bones healed. This is one of the largest orthopedic surgeries a person can have, and more intensive than a total hip replacement, and I had it performed on each hip. I was on a walker/crutches for about 6 weeks with each surgery, and the total recovery time was 6 months for each hip. This experience really showed me firsthand what our orthopedic patients go through during surgery, and taught me the important lesson of receiving help, even when you cannot reciprocate, because I was completely dependent on other people to assist me for a full month while my broken pelvis healed.
While cleaning up my diet improved many things, I was still struggling with daily headaches, frequent migraines, migrating joint pain, sleep disturbances, neuralgia, numbness/tingling in my arms, and unfortunately, my pelvic pain continued after my hip preservation surgeries. At times, these symptoms made it extremely challenging for me to work on a patient’s pelvic floor internally because my arms would become painful and numb and I would have a hard time being able to feel and palpate the muscles of the pelvic floor, which is your bread and butter as a pelvic floor PT. In 2015, I came across an article about a young female with several of my symptoms. She went from doctor to doctor and no one could figure out what was wrong. Finally, she saw a specialist and was diagnosed with Lyme disease. I went to my doctor and requested the test for Lyme and it came back positive. I am now undergoing treatment for Lyme disease. My specialist told me it would take about two-years of treatment to feel better, and that was only because I had already done the nutritional piece.
I am still on my healing journey, and take things one day at a time, but am proud to say that I am so much better than I was. I receive great joy from my global and virtual health and functional nutrition coaching practice. I feel that by helping others who are struggling, it is helping me heal as well. I can also relate to my private clients who are going through challenging times because I have been there as well. I’ve been both a clinician and patient, and those personal experiences have made me stronger, and I have learned so much from them.
Nicole: Thanks so much for sharing your personal journey, and what a valuable perspective to know the importance of nutrition for health as both a healthcare professional but also as a patient.
Check out Part 2 and Part 3 of our interview with Dr. Laura Ricci!
What is Pelvic Physical Therapy?
Dr. Nicole Cozean is the founder of PelvicSanity physical therapy, Orange County's premier pelvic floor physical therapy clinic. One of only 270 PTs to be board-certified in the pelvic floor, and the first PT to serve on the ICA Board of Directors, Nicole is the author of the acclaimed and best-selling book The Interstitial Cystitis Solution (2016). She is an adjunct professor at her alma mater, Chapman University. The PelvicSanity blog focuses on presenting practical, positive information to help patients beyond the walls of Nicole's clinic.