New Here, 3 months postpartum with lots of questions

Submitted by mermaidsd on January 26, 2006 - 11:55am
Body: 

Hello to Christine and all of the wise women of this board...

My name is Michele and I am 33 years old, and 12 weeks postpartum after giving birth to my beautiful daughter. I had planned a serene midwife attended home waterbirth, but needed to transport to the hospital, where I unfortunately received 'the works' in terms of intervention. Epidural, pitocin, forced pushing for 5 hours followed by a violent forceps assisted birth with episiotomy.

At one week postpartum, I noticed urine leaking from my vagina, I went in to see my husband's urologist who placed a catheter for 2 1/2 weeks for a vesicovaginal fistula. I had a cystogram done and got an all clear.

A few days after the catheter was taken out, I had an episode of incontinence as well as noticing a bulge at the opening of my vagina. I did a ton of research on the web and realized I had a prolapse. I was able to get in quickly to see a urogynecologist who found that I had a grade 2 cystocele. Subsequent testing found a persistent pinpoint sized vesicovaginal fistula, for which we decided to go with conservative management and I had a catheter in for another 2 weeks to see if it would heal spontaneously. I just had the catheter removed this past Friday-the fistula has not healed, and also just finished taking a round of antibiotics for a bladder infection.

I am now scheduled for surgery to repair the fistula, the doctor will be taking a small fat pad from my labia and interspose it between the bladder neck and vaginal wall to basically provide a 'stop' to the dam. I am having continuous leakage from that hole, as well as intermittent incontinence from the prolapse. The doctor has suggested that I have an anterior cystocele repair since she's "going in anyway" and apparently the site of the fistula is exactly where she would be doing the anterior repair. I am still on the fence about the cystocele repair, as I've been doing a lot of research as well as reading through this site. However, I know that I must have this fistula repaired so that part of the surgery is not avoidable.

According to the urogyn, the fistula was caused by the prolonged pushing phase with caused compression necrosis of the bladder neck and proximal urethra. I have meditated on this and I believe that it is from the incredible shearing force that was applied to the anterior wall of my vagina with the forceps...there were two people pulling and one of them had his foot braced against the bottom of the table. Too much force on very tender tissues.

Before I go on, I do want to mention that I am very holistic in my views of health. I am a physical therapist by training but have come to terms with the limitations of my profession and have gone on to do a lot of my own postgraduate learning in integrative healing modalities. While seeking the care of allopathic doctors for this, I have concurrently been seeing a chiropractor and acupuncturist, as well as being extremely mindful of my diet, and taking herbs and homeopathic remedies to support the healing process. I was so glad to have found this forum of women who are addressing their prolapses through posture, exercise, body awareness and diet, and Christine I feel your work is a gift to womankind. I am about to order your book and DVD and will anxiously await it's arrival.

So the questions I have are:
Are there any reasons why I should or shouldn't have the anterior repair at the same time as the fistula repair?

I am very aware of surgery 'setting up' the possibility of further prolapses, and there aren't any resources that I've found regarding long term study of the efficacy of surgical management. In addition, I am inferring that the majority of women who have repair surgery consider themselves 'fixed' (I use this term loosely) and therefore do not adopt any lifestyle changes (ie all of the things that are suggested in this forum) postsurgically. I will implement the posture and exercises and healthy food choices regardless of whether I have the anterior repair or not...so this is a long winded way for me to ask whether you think that adopting the techniques of the work POST repair would optimize my chances of keeping me out of the OR again? I am trying to get a better handle on the anatomy, physiology and kinesiology of the female pelvic floor (info that was abysmally absent in physical therapy school, unfortunately), and I'm trying to figure out how the biomechanics of my body might change after surgery.

I have been told that due to the surgery, I will have to have c-sections for any subsequent births. This is devastating and heartbreaking to me, as someone who had diligently and mindfully prepared herself for a natural birth at home. I believe that it was the doctors and all of their meddling and forcing of the birth process that caused my problems...I don't want to go through that again if at all possible. Is there any data out there regarding pregnancy and vaginal birth after prolapse? Right now I am still traumatized by what happened, so I can't even imagine having another baby right now, but I want to start thinking about my options for when we might decide to have another child.

Thank you all for reading and I appreciate any feedback and support. This is an amazing place and I have been uplifted by reading everyone's stories.

Namaste,
Michele

Christine

January 25, 2006 - 9:54am

Dear Michele,

Thanks so much for sharing your story. Sometimes I think the only reason we souls are here on the planet at all is to grow through difficulties encountered along the way. I

mermaidsd

January 26, 2006 - 8:31am

Thank you so much for your timely and comprehensive reply!

I think that I was leaning towards just doing the fistula repair, but your post really solidified things for me. Thank you for the anatomical information, it all makes much more sense to me and it has also helped my husband (also a PT, by the way) understand the issues better.

The doctor did mention that since the fistula is at the vesicourethral junction, the fat pad that she will be using to repair it will also act as a support to the bladder neck which might alleviate the incontinence. I am wondering too if when I am ready to wear a pessary (or use the sea pearls as I learned through these boards) that that will help with the incontinence as well. I will be having bladder studies next week. I actually do not have stress incontinence, just intermittent leakage when I am up and standing/walking. I don't leak at night when I'm lying down or when I'm sitting, just when I'm active and walking around. Could this be caused by the unsupported bladder neck affecting the complete closure of the urethral sphincter due to the position of the bladder? Also, it isn't until very recently (like last week) that I have been able to stop the stream when urinating, before that I could slow it a bit but not stop it entirely. In addition, I am just starting to regain some feeling of the fullness of my bladder, I am imagining that I have also sustained some nerve damage and the doctor has mentioned that it might take 6+ months for that to resolve. What, in your experience, have you seen regarding the return of sensation/control?

Thanks so much!

Christine

January 26, 2006 - 11:56am

The female urinary continence system is extremely complex and the best of urogynecology will tell you that no one really understands it fully. The urethra, helped by the cushioning of the front vaginal wall, does something like a spiral movement in the process of starting/stopping the flow. Yes, the bladder neck angle is all important and it seems that for some, the first sign of bladder prolapsing is slight stress incontinence due to a less-than-well-supported urethra. When the bladder comes further down, it sits more firmly on the urethra during pressure increases, so the SUI goes away, but problems with complete emptying begin.

Whether the pessary helps with the incontinence depends on how it affects the urethrovesical angle. If it lifts the bladder and straightens the angle too much you may experience leaking with pressure increases. Urodynamics testing may give you more information.

When you mentioned how your doctor would be approaching the cystocele repair, I knew you were speaking of anterior colporrhaphy. With all your research, I

mermaidsd

January 26, 2006 - 2:50pm

I will be having urodynamics testing done next Tuesday, I will probably be back with more questions then.

In the meantime I have a call in to my urogyn for a phone consult tomorrow where I will ask more questions and also tell her that I would like to do the fistula repair only.

I had been trying to research exactly what the anterior colporraphy surgery entailed...all I got from the surgery scheduler as to the name of the procedure was "anterior repair with Martius flap".

Also, just to let you know that I had my first appointment with a craniosacral therapist that specializes in trauma (specifically birth trauma), and I feel like my entire lumbar spine/pelvis and hips have released. I hadn't realized how much stress and tension I was holding in my body since giving birth, what a relief on so many levels! My acupuncturist even noticed the softening this morning, and I feel like I am walking more fluidly. I have been implementing the posture as much as I can, and I believe that with all of this combined I am actually having less leakage today. Still leaking, but I'm noticing it less. :D

Thanks so much for your very succint explanations and descriptions, I know I am at my infancy regarding learning about prolapse, I have learned so much from your replies as well as reading other threads on the forum.

deb68

January 26, 2006 - 4:16pm

Michele,

Firstly, let me say I am extremely sorry for your experience. I had a very similar birth experience to you. I also had the "works" induced, drip, waters broken, epidural, vacuum etc.

Almost immediately after the birth of my son I had SEVERE incontinence, I stood up out of bed and GUSHED urine, but never had the urge to go. I had a catheter put back in and leaked, rather gushed, urine around that also. The highs and lows of that week when my son was born still bring tears to my eyes.

I had invasive testing start within the first 24 hours after the delivery of my son, and I was found to have a "tear/defect at the 6'o clock positon from the bladder neck to the mid urethra where a balloon had been placed" and a weak spincter mechanism and bladder prolapse."

I was discharged from the hospital with a catheter, which I had for 2 weeks. Not nice.

Both my doctors (Ob/Gyn and Urologist) said it will heal with time, that was about their advice. Luckily for me I went to the baby clinic and the midwife there had just heard of a new Pelvic Floor Physiotherapist that had just started in our area. I went to see her and it was certainly one of the best things that helped me along with my healing, she helped me with pelvic floor training, bladder re-training, as my now I had not only stress, but very bad urge incontinence. But more importantly she helped provided so much emotional support, advice and guidance, and many times just a shoulder to cry on.

Once I started under her guidance, along with going to a Naturopath, Osteopath and having regular massages, I came ahead in leaps and bounds. I would say from about 3-4 months after my son's birth, things really started to improve for me. I also suffered with the "bulging" feeling and on certain days still do, but at least I understand now what it is, not one of my doctors ever told me that I would experience this and the first time it happened I was TERRIFIED. It still astounds me today how little information about your condition doctors give you, some of the symptoms that I had were dismissed by doctors, yet all the women on this site at one time or another have had them - I wonder how often doctors actually listen to their patients!!!

At present, I still suffer mildly from stress incontinence, usually only when I sneeze, or if I'm really trying to push myself to hold on. I still clearly remember have regular leaks through the day, I used to keep volume and leak measurements in my diary (as suggested by my physio) which was great, because you could celebrate every little bit of improvement along the way.

I don't come from a medical background and I found this difficult at first because I didn't really understand what was happening to me, but from reading alot on websites like this and just questioning every doctor, nurse, physio etc I saw I've come to understand and be alot less anxious about it.

When I had my son, my 2 sister-in-laws both had babies, and they had Ob/Gyn births but with relatively little intervention and no problems what so ever afterwards. This only added to the loneliness I felt after my condition, because no-one ever talks about these like this happening, in fact, all my docotrs only ever told me very little about what had happened to me and what to expect, I found knowledge certainly empowering and the support and knowledge of Christine and the others on this website invaluable.

I fell like I've gone on and on, but I just wanted to let you know that there are others out there going through what you are, and I send you all my best wishes and positive vibes for you to return to a place that you are happy with. I'm happy for you to ask Christine for my email address for you to email with any questions or just to share your thoughts with another person in a similar situation.

One other thing that really helped me is I became "selfish", for want of a better word, I called on all my resources to help look after my son and I concentrated on healing. Do whatever it is that makes you feel both physically and emotionally better (sometimes for me thats eating a tub of my favourite chocolate ice-cream). I also typed up the words to the song "I am Woman" and I put it in my cupboard and read it every morning when I got dressed.

Again, I send you my support and best wishes. I hope you find as much hope, support and positive knowledge on this website as I did.

Kind Regards,

Deb

mermaidsd

February 10, 2006 - 10:12am

Deb...Thank you so much for your kind words, I am so sorry that you had to go through what you did. One of the things that has been called to my attention with what happened during the birth it is an absolute outrage that women are having to endure issues such as this with the highly medicalized, interventionist attitude towards birth. Your post was so helpful to me, thank you so much for sharing and offering your support during this difficult time...it means so much to me to connect to other women who have gone through similar experiences.

I had the urodynamics done and apparently I have some stress incontinence but only under "artificial" conditions according to the MD...very full bladder with pressure placed on it. The MD said that since I am still in the postpartum recovery phase that this could very well resolve over time.

Also, I asked for only the fistula repair and the MD not only completely agreed with me, but was just about to tell me that she also thought that in my case, only the fistula repair is warranted because I really am not having any difficulties with the prolapse! She actually said the words "if it ain't broke...don't fix it"! I was quite shocked at this, I was expecting a bit of a fight and she was so supportive. She also said that since I am still just 3 months out from birth, and also since I am breastfeeding my little girl, that it is still way too soon to see what would happen and that the prolapse could very well stabilize and/or improve as I heal. Of course she didn't offer other lifestyle/exercise info. as I have learned from these boards which I know will be absolutely crucial to the healing process, but I really appreciate the conservative attitude that they're taking in my case.

The fistula repair is apparently a "mini" anterior repair, as the mechanism of the surgery is similiar but they will be taking out a much smaller area of tissue, especially since the fistula is so small. I asked them to take out as little tissue as possible and they said that that was already in the surgical plan.

The staff and hospital has also been really great about supporting my nursing relationship with my daughter through the surgery. Initially, they told me that I wouldn't be able to have my daughter with me overnight. I had to call a few head honchos, but they called me back within the day to tell me that my husband and baby are welcome to stay in the room with me so that I can continue to breastfeed uninterrupted. I also chose to get a spinal vs. general anesthesia to minimize the post-op grogginess.

I will have a Foley AND suprapubic catheter in for a week, then they will remove the Foley but keep the suprapubic in for up to six weeks...that's a LONG time. I am planning to rest a lot, eat well and have a positive attitude through the healing phase...I have the tendency to push myself and do 'too much' during times when I should honor my body and this will be quite the lesson in that I'm sure.

Does anyone know of any homeopathics/herbs that could support the healing process? I poked around online and found Arnica (for postop pain/swelling), Ferrum Phos. (general post-op recovery) and Staphysagria (indicated in surgeries involving reproductive organs). I will be getting some oral Traumeel as well...if there's anything else that might be helpful, please let me know. Thank you!!

UKmummy

February 12, 2006 - 9:02am

Mermaidsd,
When are you scheduled for your surgery and did you decide whether to have just the fistula repaired or the cystocele too? I am so sorry for your birth experience especially as you so carefully planned such a gentle birth. I was like that the first time too and thinking back I am sure that that delivery caused some damage to my pelvic floor as I had stress incontinence for several months afterwards. I was in "Pre" labor for three days and was finally induced and pushed and pushed for several hours. I didn't receive an epesiotomy for which I am grateful. This birth was so good though and I birthed upright so I am not sure why things collapsed now but there you go. It is especially hard experiencing something like this after a birth which should be such a happy time. I feel a bit cheated in that I have not fully enjoyed my new baby although I know that is up to me and I have to take my power back. Your comments really have helped and you sound so wise and calm about things, thank you for sharing your story. Take care!
Michelle.

mermaidsd

February 14, 2006 - 12:04am

Michelle...

Thanks so much for your kind reply, it really means a lot to me to connect with other women that are going through similar things.

I'm hoping that you're feeling better each day, know that you will 'take your power back' as you so eloquently stated...it takes time (and lots of patience) but we're all on that path.

Thanks for asking about the surgery, I will be spending Valentine's Day in the hospital, how romantic, huh? I did decide to just have the fistula repaired and the doctors are very confident that the surgery will be a great success. I am quite nervous tonight and am trying to relax and snuggle my little one while also taking care of some last minute things like laundry and packing, and I baked a banana bread just to get my mind off of things.

I can absolutely relate to your feelings of feeling cheated somehow, but I'm able to snap myself back to the present moment by holding my sweet baby and feeling so grateful for her presence in my life.

I will be taking some time to recover but will post back on the boards as soon as I can.

Peace to you...
Michele (mermaidsd)

Christine

February 14, 2006 - 9:55am

I'll be thinking of you today, Michele...Godspeed.

UKmummy

February 14, 2006 - 9:52pm

Thinking of you too today Michele and sending peaceful and healing thoughts your way! Looking forward to having you back soon!!!
Michelle.

mermaidsd

February 16, 2006 - 4:46pm

Thank you, Christine and Michelle for your well wishes!!

I only have a few minutes to post, trying to care for myself and baby...the surgery went very well. Since the tissue around the fistula was so healthy and well-vascularized, the surgeon opted to not use a fat pad graft and they only took out as much tissue as necessary. I was in the hospital for an overnight stay but am now home, thank goodness. I have 2 catheters in right now...Foley as well as suprapubic and will get the Foley out next week. The other one needs to stay in for 2-3 weeks, which is much shorter than the originally stated 6 weeks. I'm not in any pain at the moment, taking Advil on an as needed basis. Although now I am having incredibly uncomfortable itching, perhaps I now have a yeast infection due to the antibiotics? I have a call in to the doc and will hopefully get some relief from that ASAP.

Thank you again for your support and encouragement, it means so much to me!

I'll check back in and post updates when I have a bit more time...
Peace,
Michele

Christine

February 16, 2006 - 6:59pm

I'm so glad to hear you're resting comfortably and that all went well! A year from now you will probably have almost forgotten the ordeal. I pray all your symptoms eventually resolve, Michele.

Christine

UKmummy

February 17, 2006 - 9:00am

Yeah Michele,
you are doing SO well!! Rest lots, (it gives you a great excuse to simply enjoy your little one without too much distraction). Have been thinking of you, so glad to hear it went well!!! Take care.
Michelle.

UKmummy

February 17, 2006 - 9:03am

Oops me again....hope the itching is resolved, wondered whether it might be irritation due to the latex from the foley? I am sure you have it all figured out now but just a thought!:)
Michelle.

mermaidsd

February 17, 2006 - 7:45pm

Hi, Michelle...

Thanks so much for checking in on me, you are so kind!

Finally got through to a doc yesterday as I had suspected a yeast infection due to the antibiotics I was taking post-op. I am usually very much a natural healing person but I needed relief FAST, itching can be as hard to deal with as pain and I was truly miserable. Took some Benadryl to ease up on the symptoms and the MD called in a scrip for diflucan...I really don't like taking all of these medications but sometimes they are necessary. I am feeling MUCH better today, thanks, and was even able to go outside for a short jaunt.

So now that my symptoms are alleviated, I know I must watch my diet to prevent the yeasty beasties from running amok in my body again. Taking probiotics as well, to balance out the normal flora that is probably very out of whack.

And a tidbit of advice to anyone that has to deal with catheters...a good way to disguise them is to wear loose fitting yoga pants over the leg bag, then to wrap a long sarong or pareo around that as a skirt. I actually got a compliment on my pretty outfit today, this person not knowing that I had not one but two leg bags strapped to me. And it was very comfortable.

Good call on the latex foley, I had asked for everything to be latex-free from the surgery so I actually have silicone catheters. I had latex ones before and had a hard time tolerating them due to my sensitivity.

Good News! I just got a call from the doc, she doesn't want me to have to wear the catheters any longer than necessary, so she is having me go in on Monday to have the doctor on call take out the Foley for me, even though the clinics are closed due to the holiday. I will still have the suprapubic cath in for a week or two after that, but one bag is better than two!

Thanks again for checking in, your responses definitely are helping to keep my chin up through my recovery :)!

UKmummy

February 18, 2006 - 10:19am

Good, good, good! Things will get back in balance in your body, it is amazing how much you are healing every day already! Of course I am thinking of you.............
I wonder Michele, do you meditate? Hope you don't mind me asking but I used to do a lot of meditation and visualisation and haven't for a while. Kind of got lost in the pre- and post- baby busyness but it really helped me and I believe helped my body too! I had stage four cervical dysplasia several years ago and of course the Dcs wanted to cone biopsy etc. Well, I asked to delay everything and started really working on my diet, (all organics), and visualisation and working on my personal emotional healing too, anyway, three months after I got the all clear. I know that diet can have a tremendous effect on the cervix and uterus as Christine maintains. Anyway, it really seemed like a miracle to me at the time and I have not had any more problems until now. It is interesting to me that this prolapse has now happened since I have had a family and have not been looking after myself as well as I should etc. Anyway, hope you don't mind me sharing, I know it might sound a bit "kooky" to some! :)
Rest lots!!! You made me smile about the "foley cover up" outfits, there could be a whole market out there for those too!!!
Michelle.

mermaidsd

February 23, 2006 - 11:20pm

Thanks again for checking in on me, you're so kind and your support is very much appreciated!

Funny you should mention meditation, I know how powerful it can be! I am a yoga instructor (as well as a PT) and had meditated regularly before baby came along. I am aware that it can be instrumental in my healing process and haven't yet re-incorporated it into my daily routine. Pranayama (breathing exercises) have been very helpful and maybe in the next few days I can start to get a little breathing/meditation time going for myself. So, I don't think it's 'kooky' at all and in fact believe wholeheartedly that mind-body techniques are a crucial component to acheiving and maintaining optimal health.

Your story about meditation and the cervical dysplasia is incredible and an inspiration.

So I've been wearing more skirts lately to cover up the catheter bag, and I have to say that all of this has been a blessing in a funny way, I am very much a t-shirt and jeans girl and my newfound feminine attire has been really nice. I've gotten myself a few very comfortable, flowy skirts, and I'm enjoying wearing them.

Had a follow up appointment with the urogyn today, the surgery is healing well and they reiterated that they did as little as possible in terms of intervention. The hole was SO small and the tissue so healthy that they didn't feel that making the hole bigger to fix it was the way to go, so they just did a few layers of overlapped stiches to close up the hole. I will have a voiding cystourethrogram on 3/9 and if it comes back with the all clear then the suprapubic catheter will be removed the next day. Apparently according to the standard, they usually keep the suprapubic cath in for 2 weeks, but my doctor wants to make 100% sure that it all heals ok, so I will have it in for 3 1/2 weeks total. I appreciate that she is being so mindful and that she did at little as required instead of going for overkill. Today, one of the urogyns said that after I recover (6-8 weeks) that I should have no problem returning to my prior level of function and activity...however, I know that that would entail implementing the principles that we discuss here in the forum.

My mother just told me recently that she believes that she has a prolapsed bladder as well, I have shared much of what I've learned here with her and she is looking forward to using these techniques as well to optimize her very busy and full lifestyle.

I'll continue to share my journey to healing, I'm hoping that my story can help other women out there.

Peace,
Michele

mermaidsd

March 5, 2006 - 10:33am

still hanging out with the suprapubic catheter in place, it's been 'pulling' in an uncomfortable way since yesterday so i've been very mindful of my posture especially when walking, and i am happy to report that it really helps ease the discomfort.

just a few more days and it'll be out, oh what a happy woman i will be! i was joking with a friend last night about how much we take the little things like being able to pee normally for granted... i am truly done with having this bag strapped to my leg.

peace.
michele

Christine

March 5, 2006 - 10:48am

So glad you're on the mend, Michele. I bet you make a full recovery.

I had to respond to your comment on the catheter. We've heard from women who are years out from radical surgery, still self-cathing, very tired of the whole ordeal, and looking for help...heartbreaking.

It's such a joy to see young, healthy women moving in the right direction.

:-) Christine

UKmummy

March 5, 2006 - 1:35pm

Michele,
Still thinking about you of course, not too long now and things will be much more "normal" again!
Take care, Michelle.

mermaidsd

March 9, 2006 - 8:10pm

Michelle and Christine...

Thanks so much for checking in with me and for your well wishes!

I had a CT scan of my bladder today and everything seems to be hunkydory in terms of healing from the fistula repair. YEAH!

So tomorrow afternoon they'll do one more test (retrofill bladder with methylene blue dye) to check the patency of the repair, then the suprapubic catheter will be coming out.

I am SO ready to be the happy, healthy mama that I want to be.

I am saddened about women who have to self-cath, I can't imagine the reality of that.

I am just so thankful to have found this site so that I can make a FULLY informed decision to just have the fistula repair and not the prolapse reconstruction. Christine...thank you so much, you have made such a huge difference in my life (present and future) and for that I will always be incredibly grateful.

Also am so thankful that I have this forum to share my story, it's a story that I feel needs to be told, and I sincerely hope that reading the details of my journey can help another woman out there, not only for information but also for support so that they don't feel so alone.

I'll report back tomorrow after my appointment.

Peace.
Michele

UKmummy

March 10, 2006 - 8:34am

Just lost a reply I sent............Looking forward to hearing good news later today Michele! You are truly such a sunny and positive person and I learn a great deal from you through all this! Thank you!
Hug, hug, hug,
Michelle.

Christine

March 10, 2006 - 9:24am

I can’t wait to hear the final results! Nothing like a brush with sickness or imparity to wake us up to the blessing of a healthy body.

Thanks so much to you Michele, our other Michelle, and Granolamom for your thoughtful comments on my PT article. I agree Michele that PT programs need to integrate a deeper understanding of these issues! The powerful politics that keep blinders on great and many institutions is at the root of it all, but nothing is more powerful than an informed public. If our doctors and physical therapists are smart they will become, as you say granolamom, more holistic. Our culture demands it.

Christine

UKmummy

March 10, 2006 - 9:32am

I passed on details of your work to my PT and she seems VERY open to it. She agrees that there is not enough out there for these issues and sees the need for change too! All of these things are a start...............

mermaidsd

March 11, 2006 - 12:01pm

I had my follow up appointment yesterday afternoon and after she did the methylene blue test without any signs of leakage...the catheter was taken out. I am so happy!! Talk about ouch, though. The removal of the catheter was quite painful and it's still pretty sore, but am taking some homeopathic remedies that are helping a great deal.

The doctor told me to expect fairly copious leakage of urine from the suprapubic site but I haven't had ANY. None. Zip. Zero.

She checked the surgical site and it's healing very well. The other good news (besides the fact that I lost 3 pounds since my last visit a month ago despite very little activity :)) is that the cystocele is much improved, she said it has gone from a grade 2 to a grade 1. The posture at work? Entirely possible.

I requested a PT referral because I am so very weak, my abdominals are almost non-existent with how sedentary I've been due to this complicated recovery. She happily gave me a referral for postpartum exercises but I am not to do any internal pelvic work until I'm cleared at my next appointment a month from now to let the surgical site continue to heal.

She also greatly encouraged me to take some coursework to specialize in women's health PT, which I was planning to do. She said that there is a dire need here and that I would be so busy I wouldn't know what to do with myself. Well, the reality of that statement that moves me and motivates me is that there are so many women that need help...and I would love to provide not only the physical but also the emotional support especially as a woman who has experienced what I have. Of course I will incorporate the principles and lifestyle management techniques that I've learned here and as I continue to learn through research as well as my own path to health. I'm still a few years from this as part of my working/career life, as my number one priority right now is to get in shape to be the healthy, active mama that my incredible, sweet little daughter deserves.

Christine, any thoughts on developing a continuing education course for PT's? There is a HUGE need for this. Every week I get the PT Advance and there are pages upon pages of ortho and peds courses but one little ad for women's health.

Michelle, thanks again for your support and encouragement.

I know that there are many women out there who are reading this (there are 19 'guests' at this site as I write this)...please take heart and know that as women we are strong and courageous and as we share our stories and give each other support, we become even stronger despite...and perhaps because of...our tears. Hugs to you all.

I'll continue to update my journey towards wellness as it unfolds.

Peace.
Michele

UKmummy

March 11, 2006 - 2:10pm

Dear Michele,
That is truly truly wonderful news!!!! You must be feeling so great, pretty much back to normal I would imagine. You have been so stoical with all of this, particularly in the face of catheters AND surgery. Be very proud of yourself for your positivity and great attitude, and also continue to look after yourself of course. I imagine that in a few more months that cystocele will have receded completely and all of this will be a distant memory. I hope that you continue to pursue womens health as a PT. It is strange sometimes how difficult times in our lives direct us to new things. Perhaps this is presenting very real new career opportunities for you and others! Enjoy your lovely daughter with new energy and vitality, I feel sure that you are a wonderful and vibrant wife and Mother!
Love,
Michelle.

Christine

March 11, 2006 - 3:22pm

I second Michelle's thoughts! Blessings to you, Michele, and yes - holding seminars for PT's and MD's is in my bombsite! :-)

mermaidsd

July 18, 2006 - 8:56pm

Hello, all...

I haven't been around as much, with a newly mobile little one and some traveling, but I just wanted to pop in to update my story. I noticed that my story has been read over 500 times...so I am hoping that there are some women out there that are reading this and not feeling so alone and scared, as I did before I found this incredible site and this sisterhood of amazing, caring and supportive women.

I have been going to physical therapy twice a week since early April, as well as going to see a chiropractor and craniosacral therapist once a week each. The physical therapy has been very helpful, my abdominal muscles are starting to regain some strength and tone. Have also been doing some internal work with the PT, who helps with doing scar/soft tissue restriction release techniques on the episiotomy scar. She just recently told me that my bladder is quite a bit higher than it had been before!! (music to my ears...)

I haven't been experiencing the continuation of the draggy feeling, especially since working out and having improved endurance. The posture has been instrumental in this, I am completely convinced. I can now take a long brisk walk with my family (including our beloved pug) and as long as I remain mindful of my posture, I feel great. Especially helpful for me has been my upper body/neck posture. Being a nursing mom of a superchunky little girl, I sometimes don't have the best posture on the planet, so anything that helps to improve the alignment of the thoracic and cervical vertebrae has been great. Lying over an exercise ball or stretching over foam rollers feels really good, as does doing big arm circles and shoulder stretches while walking.

As for Kegels...I don't "DO" them anymore as a separate exercise, but am sure to contract and be mindful of posture when working out (lifting light weights, walking, or elliptical machine). I have been doing some biofeedback with my PT to 'check in' every few weeks to measure progress, and it's been nice to quantify the strengthening of the pelvic floor musculature in this way. Still have a ways to go, but getting there slowly but surely.

Will continue to update periodically...

Peace,
Michele

JBee

July 19, 2006 - 3:28am

Michelle, I've just spent the past half hour reading your story and I just wanted to let you know what solidarity I feel in terms of your birthing experience and the journey you're on....I found this website a few days ago when I was in despair. Thanks to some lovely messages of support and sharing of stories, I don't feel as black and pessimistic and feel that actually, progress can be possible. Your story has given me some heart that things can get better. I'm going for surgery myself now next week to repair my eipsiotomy that went pear shaped (won't repeat the whole sorry saga here). Hopefully once that's fixed I hope to be able to live with my prolapse (now I know what I've got!) and, like you, to be able to become the mother I dreamt I would be when I didn't think for a minute that anything would go wrong. I hope your healing continues to go well and that you're enjoying being able to go for a walk with your beautiful daughter. That's music to my ears! And I know from this site that it IS possible to have another baby vaginally so we just have to find a way to do that one day!
Take care and hope things continue to improve x

granolamom

July 19, 2006 - 12:20pm

I've been wondering where you've been : )
so glad to hear how things are improving for you