Qestions and need some answers...

Submitted by mamma13 on April 25, 2008 - 8:36am
Body: 

Hi Ladies,

I'm not trying to complain, and know many are in a a much worse situation than me, but I need some help and answers.

At 2 weeks PP I discovered some tissue over the opening vagina, and freaked out. I went to my OB and he gave me the news of a grade II cystocele (he made a mistake). A couple weeks later, I went to a fellowshipped urogyn and was told nothing was wrong, that my bladder was well in place (neg. 1 1/2 inside the vaginal wall, with no prolapse). I was told all I had was some drooping of the vaginal walls (which is common after birth in about 50% of woman), and to keep kegeling and all would get better. Before the birth of my son I could not see vaginal walls, just a black hole while sitting on the potty looking a hand mirror. Now I can see my vaginal walls, and the urogyn said all I am seeing is vagina, and that I have a "normal" vagina. It has got better, but I can still see tissue, and still have a feeling of somethin there. I am starting PT in June since I am still having all these weird sensations down there. I always can feel my vagina, and have some discomfort on the left side. I don't feel anything on the right side. The urogyn said it could be some of my muscles are misfiring, or perhaps a muscle trigger point. I always feel like there is something in my vagina on the left side. I feel like I am going mad - all docs tell me my vagina is picture perfect, but it doesn't feel that way (nor look that way to me). I am still nursing my son and I am 5 months PP. My questions are:

1. Is it normal to see some vaginal walls? Why did things change some much after the birth of my son (second vaginal birth- 10 lbs 5 oz was cut and tore my anus. I was black and blue down there for 2 weeks, and in a lot of pain).

2. How much should your vagina move while bearing down? Mine does not decend, just will go towards my back wall.

3. How high should your cervix be? Mine can be reached with my pointer finger, which is about 3 inches. Is that normal? Again, I am not having a period - and my cervix never changes position. And it does nothing while bearing down just moves along with my vaginal wall towards the back. It is also on my front wall. Is this "normal"? While going to the urogyn I was told that my cervix was way up there, but it doesn't feel way there while checking with a finger. But to be honest, I am not sure what is normal for me to begin with. I never really checked it before. I know it was out of reach during pregnancy. Will things start moving up and down once my period returns?

So am I crazy, I feel obsessed with this, and I can't get over the feeling as if something is wrong. Will PT help? Has anyone ever had anything like this happen? I just feel so depressed and wrong down there, but have been told twice nothing is wrong. I hate to complain, but I really need to feel better in that area. I feel like I am going mad, and all the docs think I am a nutty patient!

Thanks for your help in advance!

louiseds

April 25, 2008 - 9:39am

Hi Mumma13

I'll answer point by point.

Yes, probably lots of women worse than you, but you are entitled to be worried about you, and unexpected changes in your body. Glad you have found us.

The doctors could both be right. There are some different prolapse grading systems. Comparing these two sounds like 'comparing cheese and chalk'. The second doctor's comments would probably make sense too, as you had at that stage, only given birth two weeks previously, and it is a big ask for a body to go back to pre-pregnancy in that time. It could take over a year for your body to have finished its recovery from pregnancy and birth. Recovery happens quickly for the first few months, then more slowly, but it is still happening for about a year. Just wondering how old your first baby is?

You are now 5 months postpartum and are worried that all is not well because you can see your vaginal walls. There is no doubt about it. Pregnancy does stretch everything in there and it sounds like you had a difficult labour. Episiotomy and tearing sometimes do not heal to the formal level of tightness. That might be why your vaginal walls are showing. You may also have some damage to the fascial supports of the vaginal walls, and the vaginal walls may indeed be sagging, which is the start of prolapse. Sitting on a potty to have a look will make it look worse because your pelvic floor muscles are very loose in this position. Try not to keep looking like this, because it only makes you feel worse, and won't make it heal any quicker. A few months down the track you will probably feel further improvement.

I'm glad you are starting physio in June. This is the best way to kick start those muscles again (and I hope you are still doing a few Kegels a day - not too many - as they will help with bladder control and will utilise what muscle movement you already have). Pity you can't get in sooner. I had this problem after my second baby too. Difficult pregnancy that stretched my pelvic floor in the early weeks (but that's another story), but OK birth. I ended up having some sort of electrical stimulation therapy a few months later that woke my pelvic floor muscles and their nerves after just a few treatments, then I could do the exercises properly and get these muscles working myself. Don't worry too much. That was in 1985, and I am now 55, have a good sex life, good sensation, pelvic floor muscles that *work*. I have all three prolapses, but they don't bother me much because I manage things carefully.

Go to the homepage, www.wholewoman.com and check out the FAQ's to find out what you can do, particularly re your posture, and while you wait for the physio appointment. Apart from starting your recovery it will give you some positive things to do, so you don't worry about the negative things so much. You may find that Wholewoman posture will improve your whole vaginal and vulval area before you even get to physio.

If I sit on the potty and bear down look it all looks big and meaty and lumpy. It would scare the living daylights out of me if I looked too often! I don't!

If I stand and bear down my cervix will peek out of my vulva.

If I don't bear down and I am standing in WW posture my cervix sits about 1cm inside my vagina, sometimes lower depending on the time of the month.

If I stand how I used to stand, it would be peeking, and my vagina would feel uncomfortable all the time I am upright.

If I lie down I can only just find my cervix with a finger. Yes, it all moves around a lot, moreso after my second baby, but it didn't get worse with the third. For the first birth I had epidural, forceps, feet in stirrups, birthed on my back, big episiotomy, the works!! Vulva and vagina looked and felt different after that, but no obvious prolapses. I don't think I was sewed up straight. I think my body really was a lot worse off after the difficult, second pregnancy, and I was properly diagnosed several years after my second pregnancy (when I already knew everything had dropped). I did go on and have another baby, and was no worse off after the third, which was a natural active labour, and vaginal birth.

BTW, you are not going mad. Lots of woman have these experiences, and they are distressing, but you are doing something about it, so that's the first thing! Just because a doctor says you are normal it doesn't mean you don't feel worse and different from before. (Sorry, that might have sounded confusing. <: the="" hard="" bit="" is="" that="" we="" tend="" not="" to="" talk="" about="" these="" things="" with="" other="" women="" and="" if="" do="" are="" often="" pressured="" into="" doing="" their="" way="" so="" it="" a="" little="" pointless.="" you="" will="" get="" understanding="" here="" as="" find="" your="" through="" this="" hear="" from="" many="" who="" have="" been="" similar="" things.="">

Now off you go to the homepage, and check out the FAQ's. See ya.

Louise

mamma13

April 25, 2008 - 7:21pm

Thank you for your information! I really do appreciate it. I have come to the conclusion that I don't really have a measurable prolpase, perhaps the beginning of something, but not anything bothersome at this moment (I think). The problem I have is that my left side of my vagina from the top of it all the way down to the beginning of my buttocks, hurts and has a burning sensation. It is only on my left side. Like a kink in your neck or badly pulled muscle. At this point I can live with a bit of saggyness (which I hope continues to improve, and more so after done nursing). What I can not live with is the constant pain I have on my left side. I am miserable with it. My right side of my vagina feels so normal, and the left hurts. Some days are worse than others, and when standing or walking around it tends to get a little better. Even when I lay down on my right side, the pain is pretty bad. If I staighten out my legs it is better. It is like I have a pinched nerve or something...is that possible. I am so sick of doctors telling me nothing is wrong, when I feel like hamburger down there. Could it be from doing to many kegels? I am 5 months PP and start PT in June...but I am going insane here for some relief. And I am not kidding, it is really starting to mess with me mentally. I just want it to be better, and giving it "time" is not working for me! Thanks for listening to me complain!

louiseds

April 25, 2008 - 7:43pm

Hi Mamma13

So sorry you are having all this pain. It really points to a need to get on to the physio. I wouldn't for a minute attempt to diagnose what is causing this. Which side was your episiotomy done? If the left, then it may be connected. I went to a seminar recently on pelvic pain. Episiotomy is surgery, and they said you can expect post-surgical pain to last up to a year. After that it is called chronic pain. Big difference, eh? If the physio doesn't resolve it there are pelvic pain specialist who can help, but the physio is the starting point, as long as this is a physio who specialises in pelvic problems. Just do first things first.

Ice may help with the pain, as may warmth. From the sounds of things you just have the pain all the time. If you say you have pain, and a doctor says there is nothing wrong with you, then the doctor is not hearing you, or more likely doesn't know what to do about it. I think in your position I would be asking for a referral to a pelvic pain clinic, or at least a general pain clinic. The doctor shouldn't be dismissing you like this. That is called cruelty.

In these situations you just have to push through the wall of ignorance and beans-in-the-ears and keep knocking on doors to find somebody who will help you find your way through the healthcare maze with its secret languages and specialties. Take somebody with you who can advocate for you. They are not going to intimidate two of you.

Good luck Mamma13. You will get it sorted. Make sure you take the time to enjoy those lovely babies too.

Louise

MeMyselfAndI

April 29, 2008 - 2:27am

I am so sorry you are having problems. As you are post partum things should ease over time.

Re: Your Kegels questions - Doing too many of these really CAN make things worse. When I first got my POP I was doing well over 300 Kegels a day and doing so many of these just tires out the pelvic floor and in all effects makes everything feel worse. When I first saw my PT she said to not do more than 40-50 Kegels a day. I did that and things felt ALOT better.

Kegels are great to keep you from leaking urine but to be honest they are not the pelvic floor Olympic fixit (POPlympians? lol) . If one they were we would all be owning the sturdiest of pelvic floors. lol.

I am sorry I do not have any answers to your pain problem. But maybe if you are doing tons of Kegels it could exacerbate it a bit? Try one day without Kegels and see if it feels any better as a test? I do remember after my first baby who was forceps, I had alot of pain and discomfort for some time from the Episiotomy, and the forceps damage that happened. At that time it fel like I was either having another baby or a brick would fall out of me. (Neither happened lol)

I hope you can find an answer and get yourself some relief from this problem.

Sometimes you are holding someone else's heart whithin your hands. You can drop that heart & bruise it. You can squash that heart & hurt it. Or you can stomp on it & totally annihalate it. You stomp on that heart or bruise it. It can forever be changed.

alemama

April 29, 2008 - 1:52pm

my pain started during my first pregnancy- in my tailbone- and it came and went during the next 4 years and 3 pregnancies. It was with my last baby during my postpartum check up that I learned of my prolapse. When I started the posture (THE POSTURE) I was sore and tired for a few weeks- so much so that I forgot to notice that my tailbone didn't hurt anymore. So that was it for me.
So if you do not have a prolapse (yeah!) the posture will help you not develop one- and it may very well help with the pelvic pain.

FWIW if I were you I would find a good body worker and see if you couldn't get some relief that way.
Feel better.

oh ya and one other thing. There is an article here where you can see how to do a self exam for prolapse.