Prolapse/coughing

Yes, it is secret women's business. There is no doubt about it in my mind. In my circle of friends, I know three women who have a diagnosed prolapse - and that's only out of the people I've told about mine. All of us are under 40.

I do talk to women about it as much as I am able, because I feel that this silence is very damaging. Also, I'm a pretty open person and can say almost anything in the company of women - I don't talk about my prolapse with men in the room. I have to draw the line somewhere.

Prolapse is so preventable!! And it's so much more devastating than leaking a drop or two of urine when you cough - which is what most women (myself included, before) think is the big reason to take care of your pelvic floor. I knew I shouldn't lift my first-born after giving birth to my second, but I didn't know WHY. I didn't know that severe untreated bronchitis during pregnancy could do PERMANENT damage, or how to mitigate that damage. Same with constipation I had as a medication side effect - never knew it was risking permanent damage. No one tells women about this stuff. I see women in pilates class straining to stay up in teaser (yoga "boat pose") and I can tell some of them are not able to do it safely. I explain to them why I don't do that exercise, and they look at me like I'm from another planet.

Yes, I do feel this is not talked about nearly enough. Women are making great strides in understanding and listening to their bodies. We have a long way to go, though, as a culture.

Dear Jeanekka,
I posted this question about coughing because I had a virus and along with that a cough day and night for 3 weeks.I was sleeping lying on my back woke up with a terrible cough and actually felt my insides coming out.I thought to myself what the heck kind of virus is this I think I am dying. I must stress I was still lying flat on my back and coughing while this occured.That is why I needed to know what was the safest way to cough with prolapse or hopefully prevent it for others.I wish I knew about the whole prolapse thing also. My Mom had uterine prolapse when I was around 12 or 13 years old.She would'nt talk about it ,I was told about it from a neighborhood girlfriend.Her explanation about it at that age was that my Mother has a hernia and her insides is hanging out.She has to have surgery or she will die. I went home crying and ask my Mother if she will die because my friend said she needs surgery.She said no I'm not dying but I will have to have surgery in the future but we do not have medical insurance.So I am on a mission to try to make more woman know about this problem and to prevent this with the help of this sight and information from Saving the Whole Woman book.It is amazing when how backwards the Doctors are.I spoke to my Doctor about this web sight and briefly what I learned about the posture ,he just did not want to hear about it.Told me to do kegels every chance I get .Ride a bicycle it is a natural way to do kegels.He said this is part of getting old everything sags.I'm 59, not a spring chick ,but not ready for the grave either.So good luck and cough in a pelvic protective way.

Dr. M. B. deJarnette was the first DC to do cranial manipulation (he credited the DO's) and developed an approach to structural correction he named Sacro-Occipital Technique. He was the first practitioner to use pelvic blocks for treatment, designing them to save his own hands from having to hold the pelvis in place for many respiratory cycles. Anyway, when his patients had unstable backs, and feared they might need to cough, he instructed them to do the following to support themselves. Please tell me if this is destabilizing to our pelvic structures:

Stand up and separate your feet shoulder width, toes very slightly in.
Let your knees very slightly relax and bend, so they will not lock.
Make two fists and put each one gently against the ipsilateral sacroiliac joint.
Cough, or sneeze.

I don't know anyone whose S-I was injured if they did this.

HL

When I do this my lumbar curve is fully in place and my prolapse feels stable when coughing. If it does not give enough stability, try bending forward until the lower belly is completely horizontal. Making the belly horizontal is about the best we can do for coughing-with-prolapse. Hope everyone is making the connection that in this way the organs have fallen forward into their "pouch" in the lower belly and away from the pelvic outlet at the back of the body.

Christine

Hi queenmother this is naturegirl. A newbe trying to figure stuff out.So far I have been able to relate in some way to everyone's post. Am I correct in thinking you have had a hysterectomy? I did 8 weeks ago and at 7 weeks have a rectocele. I am not happy. I can't figure out how to cough or blow my nose. I start back to work tommorrow and that requires lifting at least 10 , 10 pound boxes once an hour for 8 hours, this would be the lowest weight of my job and can go up to 40 pounds with occasional days of 70 pound boxeswith a count of 15 to 60 boxes in a day. Think this will be an issue? Should I just get the book and DVD, as well as the SI belt because I already have issues with that and I'm reading it will just get worse. I like your name. Any info will be greatly appreciated. Thanks
Naturegirl

Hi Naturegurl

Those weights of boxes sound pretty heavy to me, for a woman who has had hysterectomy. Does your surgeon know that you are going back to work with this type of lifting work? What advice were you given by the surgeon for lifting weights from now on?

Louise

Hi Naturegirl;
In 2006 when I had my poor cervix sutured to my sacral ligaments, the specialist said 8 weeks was what I needed to heal(uterus removed) he said I could llift up to 20 lbs.. I ended up back on my feet all day ( he had said no more than 2 hrs standing- break was every 2 hrs- I found myself running to the nurse one day when doing a force test and pushing the metre at over 70 lbs. When my vagina (with bladder and bowel contents) fell out again, surgeion said lift only 5 lbs... The catalogues at work weigh 8 lbs, opening the doors must take 30 lbs of pressure.. i suffered thru all this for months because they owned me... After surgical removal of the mesh, I am adamant that I will NOT to go back to a job where noone can see nor predict outcome of my continuing to devote myself to the job--- It has been quite a dilemna for me - I like a lot of my job and the pay is good etc.... but I have not been taking care of my prolapse - at home- i keep my bowel and bladder as MT as possible, can sit and walk in posture without observation by 100's of others, I eat better, I walk in the pastures adjacent to my home. My disability insurance is only short term and this is one of the loneliest decisions for me to make - I must not subject myself to such controls as this labour has put upon me- little compensates for the discomfort of the unattended prolapse. The idiot doctor could have authorized me to not lift more than 5 lbs BEFORE his surgery and to not stand at all but his understanding was not on my side....He said his surgery failed because I lifted ...He did not authorize me not to lift...It is quite a quonundrum for the working woman with prolapse as I see it....(Dotors authorization carries a lot of respect because of workers compensation)

Dear Nature Girl and Sammy,

Could you check your Occupational Health and Safety laws? You would at least know the legality of weights that you have to lift.

Here in Australia back in the 8o's when EEO and multi-skilling took off, I had (male) friends working in the Federal Mail Service who explained that 20 kilogram bags (44 pounds) were the maximum weight limit, and to my querying the wisdom of women lifting these they explained to me that there were always male workers who were not able to lift these weights and were always given help by others, and that this would continue to be the case for female workers. I was dubious at the time....

Just in the passed few years the standard twenty kilogram weight of ink buckets in the printing industry has been lowered to 15 kilograms (33 pounds) and this is measured on what men can safely lift. I found with the plastic buckets and a cement floor that I could push the buckets along rather than carry.

We also had a big industry here in forklift trucks and forklift truck driver training because of real concerns for damage to men's backs (which was considered by the cynical as some type of con and referred to as Mediterranean back; a sling off at south European migrants who willingly worked hard and without safety precautions). There was no knowledge or mention of female prolapse. Women I think we should begin to accept are the newer edition of industry fodder who work willingly hard and without safety precautions.

You are unfortunately among the earliest women of a further generation to follow. I would be approaching my union rep, but I know a lot of people don't believe in unionization, but I wonder where else you can go? I certainly would be happy if you could have some recourse in this situation and not necessarily a financial pay out, but a more suitable employ.

best wishes

Good point, Fab. I know that our OHS people at my Australian Uni say that 25 kg is the heaviest weight that anybody is allowed to lift unassisted. I think we have pretty serious worker protection here.

I figure that 25 kg is way too heavy for me, but I bet you I could get a 25 kg object to almost any destination without lifting it myself. Combination of 'end over ending' it, walking it on its corners, lifting one end onto a slightly higher object, then pushing the rest of the way, etc. My bag trolley is my best friend.

Louise

Thanks Fab- I am not now too worried as I am getting to the age where social security will give me roughly half of my income and i have investments to help (this is another dilemna of course) I hope to be able to fight off my own attraction to heavy work.
Louiseds- it is not the one time lift but a continuous lifting that is the trouble. Lifting 10 kg all hour, all day, all week, all year sometimes It is contiunally being a burden to other aging women ....
I have to share that the insurance company has so far been warm hearted and kind though ever aware, in our conversations and has given advise for monetary help until social benefits kick in at 65 in Canada. I have a manageable lifestyle for this prolapse now- just need to get comfortable with the pessary use as it has been marvelous for the relief given.

Yes, it is easy for me to say, isn't it? I don't have to lift all day. I know what happens when I do that. It takes me several days to recover. If it just a once off I can undo the damage in no time at all, but your body would never get a break. It sounds like a really dumb idea to have a heap of older women doing this kind of work. It may seem that you are being a burden on the other older women. It is not your fault or theirs. It is the employer! I'll leave you ladies to sort that one out.

Sammy,
I worked for quite a few years for the USPS and we too were required to lift up to 70 lbs. I made sure that I had enough years in to take a "deferred" retirement and when my husband retired, I simply quit. I had to wait several years before I could start drawing my retirement at age 62 but we managed to get by. I am sure the heavy lifting was what started my prolapse problems. On top of that I owned horses and those bales of hay weigh between 40 and 50 lbs. I could manage the hay rather well though by using my knees or end over end, etc. I was a rural mail carrier though when I was working and those trays of mail are heavy and putting them in a vehicle for delivery can't be done in a really safe way in my opinion; too there were very heavy packages at times. It is my understanding that UPS workers are required to lift 125 lbs, so you don't see many women working for them.

About 6 months ago I found the WW site and it has been a tremendous help to me. If I had known years ago about prolapse, I am sure I would have taken better care of myself and at least have lifted things in a safer way. The PO was always showing us how to lift safely to save our backs but never showed women how to lift so their organs wouldn't fall out. Now that is something that should be included in safety meetings at all workplaces where women are required to lift anything heavy.
Little Bit

Yes, little bit I agree women need to be taught how best to lift to prevent prolapse. I’d imagine that what you were taught at the USPO would be similar to what we are taught here.

To lift a large object from the floor
Position yourself behind the object to be lifted.
Place legs apart at shoulder width keeping your back straight as you bend your knees (sort of like a half squat)
Then grasp the item
Then slowly straighten legs keeping your back straight as you lift the item.
(Correct me if I’m wrong.)

No way to maintain a lumbar curve here. And it sounds something like Kegels don’t you think?

Dear Sammy, I gathered from your previous post you were waxing lyrical about possible retirement. Good on you. I sincerely hope your pessary works out.

Fab, I think your method is the standard Australian method. It is also a method that I think worsened my POPs, because you sometimes have to get down lower than a half squat to get a grip on the item in question.

I took 'straight back' literally, which would have left me squatting with a straight lumbar spine and tilted-back pelvis. This didn't do my lumbar discs any good at all, and left my pelvic floor vulnerable. When I was doing a lot of heavy lifting it was 30lb bags of animal feed onto a trailer then pouring them into troughs, and moving small, dense bales of hay from stack to trailer.

I now ignore the previous method, which was OK with not very heavy weights but damaging with really heavy loads. I now half squat with feet turned out, my belly between my thighs, and lumbar curve intact, to the point where my butt is the highest point and my torso is pointing to the ground, just in front of me. I stand over the object and reach down and lift with the object with my hands just between my toes. I lift using my thigh muscles, bracing my abdominal muscles and using my back muscles.When my back is upright I use some arm muscles. Leaving the arms until last ensures that I have relaxed and erect shoulders. It is like unfolding a zigzag, with all joints straightening at the same time, and all muscles working at once, spreading the lift between ankles, knees, hips and vertebrae.

If I get a really heavy box and the hand trolley is nowhere in site, I kneel on one knee , resting that buttock on my heel with the other foot planted in front with belly dropped over the load, and feet turned well out to enable me to get in really close to the load. I lift with my hands next to my toes as normal and rest the box on my kneeling thigh, then another little lift to get it onto the thigh of the planted foot, then shift my weight forward to stand on the kneeling foot and slowly move my feet together in a half squat, with the box resting on my front thigh. Then I straighten fully, all with lumbar curve in place. This breaks the lift into several stages, with a little rest in between stages.

I have managed to heal my lumbar discs by lifting like this. i have never actually had an OHS argue that this is wrong. I think I misinterpreted the instructions when I first learned it as a teenager, which shows how interpretation can turn the right method into the wrong method, particularly for woman, in the absence of essential information.

We are told "not to lift with our back muscles". I think the word "only" needs to be inserted at the end of this rule. Our spinal processes are designed to engage with each other when our lumbar curve is horizontal and under load. As long as we *do not twist too much at the same time as lifting* the spinal processes that come out to the back and sides of each vertebrae lock into each other when under load, preventing the spine shearing off at the disc level. There are little flat facets on each process to spread these loads. The spine is an awesome piece of engineering, designed to protect itself.

Louise

Dear Louise,
Yes, I tried lifting aprox 30 pound of stuff according to your method described here and it worked and this from someone who can’t do piles or the old u pops. I think you need a confidence boost and to start to think in terms of rather than OH+S people don’t disagree with you to OH+S people need to listen and accept and incorporate your ideas into their regime. I think it is wonderful the way you have worked this out and willingly share this knowledge with every Therese, Dora and Hilda. I certainly will be taking pause to move through your suggested moves.

You just have to remember that this is my experience. I wouldn't even bother challenging an OHS person with it. They are trained the way they are trained. Each woman has to make her own decisions as to how she uses her body. I accept responsibility for what I do in my workplace. I don't expect anybody to pay me compo if I injure myself doing it my way, rather than the 'correct' way, but I doubt very much that I will ever be in that position.

Also bear in mind that we are very well looked after in Australia with our OHS laws. They are not monitored perfectly, but I think most workplaces are reasonable, just because the laws are there.

If the job has to be done you just have to do it the least worst way you can, and with the help you have available.

Louise

Fab, yes, you described the way we were taught to lift at the PO. I knew that I was having problems long before I quit but I didn't know for at least a couple of years after I quit that I was in the early stages of prolapse.

Louise, I too try to find ways of doing just about everything that will not make my POP worse. At one time I worked as a distribution clerk at the PO and since that was an inside job with other people around at all times, we could always ask for help if something was too heavy for us. I spent most of my years there though as a rural carrier and with that job you are strickly on your own, especially after you leave the office to deliver the mail. I don't know how it is done in other countries but in the US all mail carriers load their trays of mail and packages into these big hamper type containers called gurneys. These are about 4 ft. deep and about 4' X 6' in size. So, you need to bend down with heavy trays of mail to load these gurneys and do just the opposite to unload them into your vehicle. I've never weighed a tray of mail but my guess is that they average about 25 lbs. and on the average day I would have a gurney full of trays of mail and packages. There were many times that I would have more than one gurney full and would need to make two trips in and out of the office to load my vehicle. You are also ALWAYS running against time as a carrier, so you can't waste a minute. Most postal clerks have no idea what a carrier goes through. I know this because I have worked in both positions. Anyway, at home now I can do things in a much more relaxed manner and can take the time to think about how to do things without putting a strain on myself, especially my POP. I have worked for several different POs in the US and have had numerous supervisors and it is the same here in all offices. They have a certain way of how everything should be done in the most efficient manner and everyone is expected to do it in that way if they want to keep their job.
Little Bit

Dear Little bit

I know it sounds a little disquieting to say well, maybe it is just as well you did not know your problems were due to prolapse while you were still working, or you may have been tempted to go onto worker’s comp or health insurance or similar and go ahead with whatever operation the doctors thus involved would have then prescribed and risked possible worsening of your condition, but I think it a real consolation; a rare case of ignorance being bliss especially as you have made much improvement from your own efforts.

Knee and back injuries occurring at work also spring to mind as another risky area where all parties involved are keen for a timely return to work, and where, despite all good will, second and third operations prove the case and still the knee or back is not right. In contrast, there are cases where the knee is given time to heal and there ceases to be the need for an operation.

Many a small business has gone to the wall as a result of a compensation claim giving rise to an exponential increase in insurance premiums that the business cannot afford. In cases of fatality, the employer faces possible criminal charges.

No matter how good our legislation, we cannot protect people from wrong headedness, a mischance in a million or even the, what to some minds is a, frustratingly inevitable but easily preventable mishap. When these situations arise no matter which side of the divide you may find yourself, it proves a lose-lose.

More good reasons for our daughters to understand the risks of prolapse involved in lifting and carrying weights, but we can’t kid ourselves that many of them for all sorts of reasons will continue to take the risks anyway. But forewarned is forearmed. Who amongst us older ones would have once believed people would voluntarily stop smoking?