New Here, a few questions

Submitted by rembr2pray on July 14, 2010 - 8:05pm
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Hello!
I'm new, joined a few months back, but got sidetracked w/life and "found" this site again :)
I have 3 children 5, 3, and 1 yr (today!). All three were natural non medicated midwife assisted births. My 1st had craniosynostosis (premature fusion of the openings in the skull). We of course did not know this when I pushed for 3 1/2 hrs to get him out. I tore significantly, and at the time there was a little "debate" amongst my midwives as to whether or not I needed to go to the hospital (my births were at a birthing center) to be sewn. In the end, it was decided that they could do the repair there and all was well... sort of.
After this birth I experienced some of the pressure that others have mentioned, but thought it was completely related to just having a baby. I never even said anything to my midwives. I went on with life as normal. 22 months later had another baby and 26 months after that had my 3rd. After my third I decided I needed to see someoone about my hemorrhoids which I was told was a common thing for women who push rather intensly during birth as I did with my 1st (the hems were there ever since that point)
So I go in to see this rectal DR, which was a completely new and uncomfortable experience. (I'm a bit shy even seeing my OB for my yearlys!) I was expecting him to report something like "oh it's no big deal we'll just remove them and all will be well" What I got was shocking and I'm still recovering. I was told that I had a mild rectocele (this I now know is also quite common to some degree for post partum women), my hemorrhoids are mild/mod but they are actually doing me a favor... apparently I have nothing left of my perineum except scar tissue. What's supposed to be as thick as one's finger, in me is about as thick as a few sheets of paper and the hemorrhoids are actually providing me with some control over my bowels.
My options were presented to me that I could have surgery to repair the perineum and they'd then fix the hemorrhoids at that time or wait to see if anything really happened as a result of my current state. I asked what could happen, and was told that as I age and lose abilities anyway that I'd eventually lose control of my bowels and not be able to hold back when needed. I was absolutely mortified.
I've had some time now to process this and speak w/my midwives (of whom I don't blame at all for this, even though I probably should've gone to the hospital after my 1st. It's hard to tell for sure what's really going on without doing full exams and they did their best). I realize that it could be years before I have real issues, but I'm already experiencing "close calls". I simply can't wait to go to the bathroom at all or else I risk not making in time or just barely. Many people have spoke of constipation as a problem, but I have the opposite problem.
What I'm wondering is 1st, if I'm in the right place :) 2nd if beginning the exercises recommended in the Whole Woman will benefit someone like me? and 3rd If not, can someone guide me towards a better solution? Thanks for listening. It helps to be able to talk about it, even though it's also somewhat of an embarrassing tale.

melhop

July 14, 2010 - 9:14pm

I have very little perineum left after birthing a 9 pound 14 ounce boy 32 years ago. I got the recommended episiotomy, but still torn inside and out. He was a face up, forceps baby. I might have 1/2 inch perineum. I have at least three prolapses. and was up for surgery last summer. This is the place to get information, and nothing is too embarrassing for us to talk about. Sometimes, we can even laugh at our situations. There will be others who will answer this thread and give great advice. I just wanted to welcome you. After a year of postural work, exercises, and diet, I can do whatever I like. I don't think I will ever choose surgery.
Melly

rembr2pray

July 14, 2010 - 10:04pm

Thank you so much for welcoming me. :) I'm so glad to have found this site. It's good to hear that others have gone done the same road I'm headed for. Thanks for responding :)
Stephanie

louiseds

July 14, 2010 - 11:05pm

Hi Rmbr2pray

You are right. What is done, is done. We just need to move on and deal with what we have. So glad you have made the move and come back and start having a more careful look at what you can do for yourself.

You don't say how much you have learned so far from this site. I can understand your reticence about letting any doctor have a look. They always seem to be full of bad news. I think the fear of the risk you take in opting for surgery goes up against the fear you have of not having surgical repairs. It is not a nice place to be standing.

Well, we are not gong to cut you up and sew you back together again, so there is a lot of fellowship here that might get you through your fear. Fear is not a good place to be when you have decisions to make.

My understanding is that urgency with your bowels is related to the functioning of the outside sphincter of the anus. Do you always have close calls when getting to the toilet, or is it only sometimes?

The other question is whether or not the hemmaroids bother you all the time? If you have the hemmaroid op without the repair you might find yourself worse off, or maybe not. I cannot for the life of me see how hemmaroids can help hold the anal sphincter closed. I would have thought they would prevent it from closing properly, and that having them removed might improve your situation. I thin you need a second opinion with this.

I suggest that you learn as much as you can from Christine's work, via the DVD, the book and these Forums. Give it all you have, posture, diet, clothing, lifestyle and environment, and exercise. Learn to firebreathe (from the book) and/or nauli and do them several times a day when your rectum is not full, which will help suck your rectum up, further inside your body, where it is meant to be. This will help the hemmaroids position themselves further inside.

I do not know to what degree they can resolve themselves. Perhaps somebody else knows. Sufferers say they come and go, probably a bit like POP itself. You have your days.

There are quite a few women who live with a minimal perineum, Alemama in particular. She has not posted for a few days. She has a sick child at the moment. It is a pretty common thing with POP, so I am sure that you will get responses, and that these women will be able to give you more firsthand help than I can.

Louise

rembr2pray

July 15, 2010 - 1:20pm

Thanks Louise!
I think you're absolutely right in that being fearful of what "might" happen if I don't have surgery and actually having the surgery itself are both huge. I do know that for the present moment, I've opted not to have any surgery (hemorrhoids or perineum repair) because I'd like to try this approach first. Also because I have 3 small children who aren't able to handle mommy recovering in bed for up to 6 wks (that's what they said it could be :( ) But I'd absolutely love it if I never had to have surgery. I've known a few moms who had the perineum repair right after birth and all have said there was extensive recovery, not just the typical 6wks postpartum.
Currently, I don't have close calls to the bathroom every time, it's just sometimes, mostly when the stool isn't solid. Also, so far, to my knowledge, I haven't had any prolaspe of my uterus. I'm of course assuming this would be something that I'd be aware of if it happened, right?
My hemorrhoids are actually getting better on their own since I'm now at a year postpartum. They are minimal now and very very rarely flare up or cause me issue. I'll admit that I'm glad to hear you confirm my thoughts about the hems. being removed. I too though it odd that they would help hold things in.
After I met with that DR (he's not my regular dr , just someone I saw for this specific reason) I did reading and found out that one's OBGYN is actually more suited and well trained to handle issues w/the perineum. I had only been going to my midwives up to that point, but have had an initial visit w/an OB. I really like her a lot. She was referred by my midwives and is very natural in practice (she actually had home births her children), so I think she'll be supportive of my choices to try the whole woman approach 1st.
As for what I've read, it's not been much yet. I've been on The Whole Woman website and read briefly the overviews there. I've also read a paraphrase of the book. I'm planning on purchasing the book and DVD soon to get started. I'm incredibly grateful for this forum and feel very fortunate to have found it. Thanks again!
~ Steph

Christine

July 15, 2010 - 7:35pm

Catchy little phrase for a radical movement, don’t you think?

At this point in time, coaching birthing mothers to push should be punishable by law. I understand you may have had extenuating circumstances, but generally speaking...

I just want to point you to an article I wrote several years ago that helps explain anal sphincter damage and offers a guideline for those seeking treatment.

I, like almost everyone of my generation, have virtually no perineum left after two episiotomies. However, we can thank the Divine Creator, Infinite Intelligence, or Mindblowing Evolution for the flawless design of the anal sphincter. Only someone with no perineum could know the value of this big, bulky, yet highly sensitive muscle.

Louise is right. Get your weight off that area with the WW work and give your intestinal tract all the support it needs to function at its highest. The alternatives are not even worth exploring.

Wishing you well,

Christine

granolamom

July 15, 2010 - 8:47pm

hi there, rembr2pray and happy birthday to your little one!

don't have much time right now but wanted to let you know that the little bit of perineum I have is a big ole mess of tears that never healed properly. and while my issue is primarily bladder and not rectocele (though I do have a small rectocele as well) the WW posture and exercises have made a huge difference. I personally do not expect to completely get rid of my prolapses, but I am happy enough to be symptom free. more than any of my mw's or dr's thought I could be with my mangled bottom. I've given thought to having it all repaired, but I'm afraid of surgery, afraid the surgeons won't be able to hold themselves back from 'while we're in there we tacked up your bladder for ya', afraid of what more scar tissue would do (or not do). so I chose to give this non invasive method a fair try of a year and reassess at that point. I'm so glad I did!
I think you have nothing to lose by trying this first.
and maybe play around with your diet to prevent loose stools.

alemama

July 22, 2010 - 10:00pm

but I still have an intact anal sphincter (it's like the little engine that could) and so I feel great! (a little unsupported- but great!)
Sounds like you tore through yours. Darn it! You know you can check it out right? thumb in your vagina and first finger in your anus and feel the thickness and also the strength as you squeeze (kegal)-
don't know what to tell ya about surgery for torn anal sphincter-I know if I tear through mine you bet your bottom dollar I'm gonna have it put back together and I'll go through the E.R. too- so I'll get whoever is available for that sort of thing- and not some amazing specialist- but it's one of those surgeries that is much better done right away.
so if you do not have an intact a.s. (s (hahahaa) and it's been that way for a while- what they heck, just leave it. if you start having probs- well- then think about surgery- but sounds like you are doing great! (though I'm thinking the surgery for a.s. repair isn't really like rectocele repair- for a.s. they just sew the ends of the sphincter back together- but really I have no idea- never watched one- and I wonder if old injuries the a.s. is so far retracted they have to do more extensive surgical work- ack I know nothing- ignore me- I need to look it up).
all that- and I just wanna really say- YES! do the wholewoman work. You will not regret it.

rembr2pray

July 25, 2010 - 12:09pm

Sorry I've been away this past week. We had a joint party for my 1 yr old and my 5 yr old (their b-days are just 3wks apart). :)
I really appreciate the support and real stories from others who have very little perineum. I'm definitely going to give whole woman a try. It can't do any harm and hopefully it will do all the good.
So thank you all again. I can't even say enough about how good it feels to not be alone in this. I'll be honest that I'm usually a forum "lurker" and rarely post, but I just wanted to let you all know that I'll be reading and practicing and I'm glad I'm here.

JDsmommy

July 26, 2010 - 10:02pm

OK, this is kind of stupid question, but how would I know if I had little to no perineum left? I had never thought about it before reading this thread, but now I'm wondering ... Basically my perineum area just feels like a big bulge ever since I had my son (14 months ago). I did not have an episiotomy and was told I only had a minor vaginal tear.

Thanks,
Carrie

granolamom

July 27, 2010 - 9:41pm

not a stupid question at all, and honestly, I'm not even sure I know
but my guess is, take a look at how much intact skin you've got between the anus and vagina. like how far apart the holes are.
you can also get a sense of how thick/strong your perineal body is (the support structure inside there) by inserting a finger into the rectum and one into the vagina and the perineal body is between.
now you'll want to know how big it 'should' be and I have no clue. I'm sure its come up before, but its one of those things I ignore because mine is what it is and I dont want to know what it isn't (make any sense?)

aza

July 29, 2010 - 12:13pm

They are all completely different. Just like breasts, no two perineums are created equal, and they all change through the years, too.
Visually checking out what is between your vagina and anus is a good start. Feeling just inside your vagina for the first layer of skin and tissue will give you another dimension of depth. Feeling with two fingers vaginally and anally will give you yet another 'view' but this will be more indicative of your anal sphincter than perineum (sphincter will generally feel like a botoxed, thick and tight lip and once you get past the sphincter the tissue feels quite thin between the vagina and rectum - your fingers will be able to make contact with each other on either side of the tissue).

heavenly

July 29, 2010 - 12:52pm

Never mine the perineum, I can't think of touching anything down there.LOL To soft and afraid of what is there. I tried it a couple of times and almost fainted. I know it is my body but like to know it is there from a distance. Never felt such "stuff." Yup and I am 62, guess I had better figure it out soon, ya think! Almost fainted again a few months back with an ultra sound when they handed me a large penis looking thing and said to insert it so they could see on the monitor. Well, thought I was going to have an "out of body experience." I made it through Praise the Lord!Guess I had better get with the program gals.LOL

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