Not necessarily a fun 'sode to do, but we wanted to revisit The IC Solution - written almost 10 years ago now - to see what we got wrong or would change if we wrote another edition.
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We talk about the book-writing process, how we wrote a good chunk of it in a oceanfront pool in Mexico, and what our goal was for patients.
The book has been the best-seller in it's Amazon category and reached nearly 25,000 patients. And it's something we're incredibly proud of.
A lot of things in the book changed opinions or have aged really well. The American Urological Association added our 'no kegels' rule for treating patients with IC to their 2022 Guidelines.
We showed in the book the evidence for Elmiron helping patients was very weak and almost certainly didn't outweigh the side effects.
There was a major emphasis in the book on 'nervous system upregulation', which we would now call more 'central sensitization', even before much of that research came out.
But three things we got wrong (or would do differently if we wrote it today):
Using more 'trigger point' language than we would today. As it's a patient-focused book we might have left the term in, but our explanation of it would have been very different and focused more on global overactivity.
Vaginal estrogen. If written today, with all the research that has been done, this likely would have it's own chapter or a long section. We didn't have any mention of it in the book.
How to find a great pelvic therapist. Our goal for the book was to get people with IC to go to a pelvic therapist. We didn't put in resources for helping them find one who was a great fit or give them the right questions to ask.
Hope this has been helpful to see how opinions evolve and change. Anything you put out into the world won't be perfect in 10 years - just put it out!
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Nicole Cozean, PT, DPT, WCS
Founder of Pelvic PT Rising and PelvicSanity Physical Therapy in Southern California.
Dedicated to forever changing pelvic health with online clinical courses to help you be more confident in your practice and business resources to help start and grow pelvic health businesses.
Jesse Cozean, MBA
Co-founder of the Pelvic PT Rising and the Rising Podcast.
Jesse uses his business experience to help pelvic health business owners start and grow their practices so they can build a practice that truly works for them. From website design, SEO, conversions, marketing, finance and money mindset, he wants to make the process of owning your own practice easier and fun.