Pessary - feel left alone by drs

Hello Body! I have a minor to moderate prolapsed bladder. I found this wonderful website that is comprehensive in providing information to women experiencing prolapse of any kind. Thank you, Christine! I bought the book, "Saving the Whole Woman" and absorbed it like a sponge. IMO, this is such important information that it should be shared and read by every woman who is facing a prolapse.

I finally got in to see a urogynecologist two days ago. I had to wait 2 months to see him. Ridiculous. However, my appt with the doctor turned out to be thorough. He spent an hour with me. He told me that he has patients whose prolapse was similar to mine and their prolapse has not worsened over time. He gave me the expected 3 options: surgery (not recommended in my case as it's too minor), pessary or do exercises to help strengthen the pelvic muscles. I have been doing the WW exercises and postural changes that I am able to do for the past 2 months. I can't say there's any difference...YET. But I haven't been at it for very long.

I did opt to try a pessary to see if I can better keep my bladder from dropping lower into my vagina to give me a little more confidence with my daily routine. I also mentioned Christine's research and book to the doctor.

My goal continues to be that I will be able to have the same level of success that other women here have discussed. Basically, no prolapse! I don't feel the pessary at all and have been able to return to many things, pre-pessary, that I did prior to the prolapse. But I do not lift anything, do weight lifting exercises, or anything else that could worsen my condition. I'm very careful to continue with the WW exercises and posture while wearing the pessary. For me, it seems to be helping. Putting it in, taking it out and cleaning it has been very easy for me.

Hopefully, this long response provides you with some helpful information.

FunnyFootGirl

It's a good question. I've only had the pessary for a couple of days and it has definitely NOT gotten stuck, doesn't fall out and is very easy to remove and insert. The doctor showed me how to insert and remove and then asked me to do it myself while in the exam room. I was amazed at how easy it is to insert and remove. I feel very confident that it won't fall out and it hasn't fallen down into my vagina even though I've worn it for full days.

This is kind of a delicate subject but...The only issue to contend with is when you have a bowel movement. Sometimes the pessary has moved slightly downward and I simply pushed it back up. As part of the learning process, the first couple of times I had a BM with the pessary in, I put my fingers just at the vaginal opening to make sure the pessary didn't fall out into the toilet. I did take it out and reinsert it once after a BM. I have NO issues with constipation any longer (which is what got me here in the first place) so the pessary falling down a bit isn't a result a pushing or straining. It can just happen sometimes when you have more to void.

Hope this helps. Feel free to ask any question! That's one thing I love about this forum. It's okay to talk about what might otherwise be considered "indelicate" issues. Sure wish this particular subject matter wasn't so taboo in our society. It's important to understand prolapse.

All the best,
FunnyFootGirl

My pessary (~8mos) is so good and so bad. it definitely holds up my heavy bladder and makes my life near normal. However, it being like a bagel in size it is always stretching me. When in, the chemical smell and a discharge the colour of the pessary are not acceptable. What I would like is a pessary small enough that I can remove it every night and not wear it if I have a relaxing day in store reading or other sit down activity but that I can easily pop in for support when required. I am in Canada and have not had luck with finding sensible help for this condition. Am still looking. After 8 months of usage I realize I cannot wear it continually but need it as an option to tolerating the weight and annoyance of my bladder sagging. I will try to get a smaller one- I feel the optimum size is going to be ok for me. Why would anyone operate on me when all I need is an insert I can remove to keep me in shape... I have felt the lack of interest from gynos who don't care to take time with pessary usage

Hi,
Some months back I bought a pack of sponge pessaries and had no success with the one I tried. I lubricated it, trimmed it again and again. Finally, I decided I must not need one since nothing I attempted worked!
The biggest lesson I have learned since my cele diagnoses last Spring is that I must not ever strain with bowel movements. I begin the day with oatmeal, prunes and a flax seed capsule and water throughout the day. I end the day with another flax seed capsule; also I eat no white flour carbs. This practice allows me (usually) to have 2 bm's a day and my large intestine is never heavy or "stuck." When I do this I have no pain or pressure from prolapse and can go weeks with no sense of prolapse!! I can't believe it. I have been able to postpone surgery in 3 month stalls since last summer. Yeah!!!
When it 's time to show up for my postponed urology meeting to discuss surgery I buy myself 3 more month of stalling (basically I re-schedule for 3 months down the road) while I work to get my system and lifestyle working for me instead of against me.
I lift nothing over 5 pounds, nor move furniture anymore; if I do I pay with that heavy low feeling in my vagina. I also walk and sit as Christine describes and only allow myself my recliner (gasp!!) when I'm on computer at night for an hour or so. Christine's exercises can be done step by step and not only in a prescribed 30 minutes session. I notice myself always thinking now of how I am stepping, walking my dog, standing and so on.
Last week I had a stress test on a treadmill. Well, I hated that and my bladder is still getting back into place after the fast walking. I hope to get back on my inversion table as soon as I re-configure the restraining belt. Straight-legged inversion isn't such a good idea, so I am designing a wrap for my waist rather than just ankle cuffs. I want to be restrained at the waist, so that my legs can bend at the knees.
I hope this helps someone. Best, Daphne11

I just want to add for Izzy2new that this absolute abandonment by the unenlightened and untrained medical personnel when it comes to these issues of Prolapse is not only crazy-making and difficult to comprehend it is unconscientable. However, they truly don't know and haven't been trained. How is this possible when we can make babies from frozen sperm, document mountain ranges under the Pacific ocean that we can't see, and determine distance in light years? It just is. The whole issue of this medical abandonment is, for me, like the silence of abuse. No one's been talking!! until Christine. Thank you, Christine, for the forum, the food insight, exercise and wellness info and the promise of a better tomorrow for each of us. Daphne11

... will you stop making appointments with the urologist? Why do you keep going (not an accusation, just curious).

Hello Daphne11, I'm glad that you are joining in with this discussion. It's an important topic for many, many women "out there" who live with prolapse. The urogynecologist I saw took measurements to determine the pessary size. He said that the size he recommends for me is a size 3. It's small enough to easily put in and take out every morning and night.

You also brought up the issue of household tasks that we should limit (e.g. no lifting above 5 lbs, no furniture moving, no picking up the grandkiddos :(, etc.). Absolutely NO straining with BMs is critical in helping us to have a little control over any worsening of the prolapse.

FunnyFootGirl

Hey all, I would just like to clarify.

Funnyfootgirl just stated guidelines of limiting household tasks, "eg, no lifting above 5 lbs, no furniture moving, no picking up the grandkiddos". I think we need to be mindful of how we do all these things, but we don't have to 'not lift' anything over 5lb; we can shift furniture as much as we like, as long as we do it sensibly, using our posture and mechanical advantage and appropriate devices in appropriate ways.

Grand kiddos are a different matter, varying from tiny to 'far too big for anyone to lift'. You have to use your judgement (and your posture) here. We have chairs, sofas, beds and floors. Grand kiddos have legs and lots more bounce than we have, and climbing is their specialty. There are lots of workarounds that don't involve lifting wriggling, strong, restless little people. I wouldn't feel limited at all by these activities. However, by the same token I would not seek out or continue a job that required me to do these things as a condition of employment, where I did not have a choice.

NB A woman has hysterectomy or prolapse repair surgery needs to abide by any rules that her surgeon has set.

As you rightly state, Funny, no straining is absolutely critical for POP management, possibly as important as posture.

Louise

Sorry funnyfootgirl, but I don't buy those "rules" one bit. I have been doing this work for three years. Had another baby too. I work on a busy inpatient unit of a hospital. I regularly lift/ adjust/ turn/ push all manner of people, equipment, and furniture way over 5 lbs. Then I come home and lift my 6 month old and three year old as needed. I exercise with weights. I haul 4-5 days worth of groceries up a few flights of stairs. I have seen nothing but improvement as long as I am in WW posture -- the weight bearing only serves to enhance improvement. Of course, individuals should do as they feel they need to stay "managed" but don't automatically dismiss the ability to live life as a strong woman who does what she wants. This work can set you free!

Hi Louiseds,
I won't stop making the appointments. I will continue to make my appointments and re-schedule them as I described. My doctor understands what I'm doing and appreciates 2-3 weeks notice during which a really needy woman will be able to be scheduled (as an emergency). In this way I allow myself the window of time I need in case of my own possible emergency. I don't believe that I have this issue under control; I just feel that I'm maintaining but not getting better. Now that you mention it, I realize that I'm keeping a good surgeon on hand for when things get worse.....hmmmm. I don't feel like I've overcome anything to the point that I could let go of the 'surgery' option. Any help on this point?
Daphne

Thank you. I just read some further comments and realize that maybe I have more work to do. I may be in a 'walking on eggs' mode of thinking. If I could get to a point of more confidence and understanding maybe then I wouldn't feel at the mercy of prolapse, which definitely I do feel. I don't feel strong; I feel fragile. Realizing that, I see that better prolapse health is possible for me. So ...more work to do on posture and strength training.
In the past year I've been diagnosed with prolapse, interstitial cystitis, bone fractures due to osteo and heart issues and my valued doctor of many years has relocated. I do feel like I am walking on eggs!
Thanks again for your insight.

Oh Daphne, i am sorry to hear about these health issues. No wonder you are walking on eggs! I would be feeling a bit vulnerable in the same situation. There is no harm at all keeping in touch with your surgeon as long as you are doing the judgements and not falling under the spell. You know enough about your own body to decide for yourself how to handle this. I really was just wondering.

On with the work, with a new perspective.

(((Daphne)))

ps Sometimes I think one of the benefits of staying away from doctors is that you don't find out about all the things that are going 'wrong' with your body. Doctors can have a way of finding abnormalities, via screenings and scans and path tests, and it can make you feel like your body is falling apart, and it can make you feel vulnerable to know about these things if you are told about them.

However, *some* of them are not really treatable anyway, or the treatment is not shown by good research to significantly improve the outcome, and *some* are just descriptions of abnormalities that have no proven medical significance, though they are measurable. It takes a very skillful lay reader to tell the difference once you are inside a medical system that is hell bent on 'treating' you for something!

Ultimately, we will all die of something, and if we live into old age there will be lots of parts of us that will be on the way out, but will not contribute one bit to our final demise. It really is about living well with an ageing body and remaining active for as long as we can, and seeing our way through the bull **** that, designed to improve out lives, can do the opposite if not used judiciously.

Louise

I was just diagnosed with a prolapsed bladder on 2/7/12 (stage 3) No recommendation of a pessary yet. I ordered the book, Saving the Whole Woman, and am anxious to read it. I feel like I'm afraid to do anything. I don't do yoga now, nor pickleball (played on a tennis court with a plastic ball), no bike riding. What has it been like for others with a prolapsed bladder. I have to talk to the doctor and ask what my limitations are other than no heavy lifting, no core exercises, no heavy furniture moving, etc. I've had several sleepless nights just worrying about this. Will my life ever be normal? Thanks for this wonderful forum. Lady Jane

Virtually every one of us knows that feeling of worry and panic. When I first got the book, I devoured every word. It has now been a year and a half, and I doubt that a week goes by that I don't pick it up and reread sections. The posture principles really do work, and Christine's own story will inspire you to carry on. So just hang on! Search this forum, and all the resources of the website (lots of articles, plenty to read!). Welcome and good luck! You are in the best of company here. - Surviving

My 90 yr old mom who had 16 children is in hospital with a broken hip..they put a plate and pin. I can truly see what a remarkable person she is... so much family and friends from a long and busy life.

For Daphne11 - I had surgical help and am back to the same issue- surgery failed leaving me really not wanting to try again though I think some doctor would be happy to have me fill his schedule. I do love the pessary but need sthg i can control more.

Did we question the surgeon who said mom needed the plate in her hip?? not at all-

Of course she is suffering from the incision and the medication and the abrubt halt to her comfortable old age but she is such a strong woman. Damn ice....

Thank you Surviving60 for your encouragement - it's just what I need. I'm looking forward to reading much more on cystocele and rectocele problems and what other women do to control and help these problems. Lady Jane

True words indeed, Sammy. Give your Mom a big, very gentle hug from all of us here. We hope she recovers well.

My Grandma broke her hip at about 98 years of age and went on to walk again. It was horrible during the acute stages of healing but was far better that having her bedridden for several months while the bones knitted, which they might not have done, as she had very brittle bones anyway. She lived to be 104 years of age, which would have been a long time to be in bed, waiting for a painful fracture to heal.

Louise

I love reading all the comments in this forum topic! Thanks to all who have jumped in to add input based on their own experience. We are definitely all different, have different stages of prolapse and deal with varying medical issues that may complicate the prolapse.

To clarify about the lifting no more than 5 lbs issue, I was responding to a previous comment and referred to her reference of not lifting more than 5 lbs. I have found this to be true for me as well. But it isn't just due to my bladder prolapse!! I have a very painful and difficult-to-live-with nerve disease and a mangled foot. These issues contribute greatly to my inability to lift more than 5 lbs! The prolapse just adds one more medical issue into the mix. So, for me, I must abide pretty strictly to some physical limitations because I either can't do it anymore or doing something will put me in bed for several days with excruciating pain. That's why I entered the subject field of "We're all Different" . I would love to have my life back enough so that I could do the physical things that bad_mirror says she is able to do! It's so wonderful that she can do so much :).

Louise made a comment that really impacted me when she talked about not going to the doctor too much. It seems that so many doctors I have seen are always finding some "reason" for me to see them again or have some test done. It's a merry-go-round that I want to get off. You have inspired me to take some control back by not falling into this pattern. It's a decision that everyone needs to make for themselves. But I'm going to be more selective about how often I will see a doctor. I know my body pretty well and think that I can usually tell if I need to talk to a doctor.

Keep on posting!
FunnyFootGirl

Hello FunnyFootGirl5,
As I read your comments I could just see myself fishing a pessary out of the toilet and figuring out how to completely sterilize, all the while swearing madly!
Thanks for your helpful words.
Daphne11

Those rules -- hmmm
Well, yeah for you. You are one of my new role models. Thanks for the vision of freedom to live again.
Daphne11

I can see the reality TV series. It would be called Down There. I think you would probably be evicted for swearing when you lost the pessary in the toilet. Do not pass Go. Do not collect $200.

LOL!

Louise

Probably the conversation would go "bleep bleep bleep!" D

Well, that would make for a pretty boring sound track, eh? Perhaps that series would be a flop? We won't do it then. ;-)

Izzy - I've no personal experience with pessaries, but I read this forum every day. I know that some women who use them will take them out at night, and sometimes choose not to wear the pessary at all, on any given day. Others see their doctors periodically to have the pessary removed and cleaned and to have themselves checked. What you are describing doesn't sound very appealing. It doesn't sound very safe either. Are you starting to work on Whole Woman posture? Pessaries have their time and place for many women, but at the same time, I would hope that it isn't the only thing you're doing for your prolapse. - Surviving

after about 8 months with a donut pessary, ( during this time it was out for about total of a month) My vagina does react to the pessary - more fluids and colour. It seems for sure to me that doctors especially specialists simply do not have interest in the pessary. Then we need health care workers farther down the hierarchy do be there for this purpose.. At on point in a visit with a gastrointerologist( before surgery to remove mesh) She asked if I had feces from my vagina--I have never heard of such a thing but am now wondering if pessary wear in any way could cause this kind of problem---

urogn told me "can't hurt yourself by putting it in and only wrong way is if it falls out"(donut pessary)
The vagina is not a limitless cavern- too bad pessaries don't come with a string of some kind like a tampon-- we would have less fear of getting stuck. Mine has never got stuck - it is just so big that I tear myself upon removal so am hoping for a smaller size. Because of increased fluid I hope to be able to remove at night

I would be pretty disappointed with a doctor who wouldn't show me how to use a pessary. It's very easy for me but I realize that this may not be the case with everyone. It may be easy for me because the urogyn spent sufficient time with me to show me and watch me do it myself. I would definitely not leave it in for days at a time. The correct size is an important factor in your comfort level and ability to put it in and take it out. I agree with Surviving that leaving it in for long periods of time does not sound safe.

The fact that you tear yourself when removing the pessary, Sammy, certainly seems to indicate a wrong pessary size. That just doesn't sound right to me.

I've talked with 3 doctors about using a pessary and all of them seem to be in agreement that it can be very helpful for some women with prolapse. So far, I'm very happy with the results and the additional confidence it gives me. BUT, it is not a substitute for WW posture and exercises to improve prolapse. I believe that continuing with this work can lead to a better quality of life which is what I want. And if you're reading this forum, I would guess it's what you want, too :).

Before getting the pessary I was using tampons to help keep my bladder prolapse under better control while trying to get things done. I've found the pessary to be far superior to using tampons...so far.

FunnyFootGirl

Hi Sammy

That was a nice little scare tactic, wasn't it? I guess she was referring to the potential for the pessary to be putting point pressure that you might not feel, against the vaginal walls and causing a fistula between the rectum and the vagina by denying blood circulation to that point, which would be theoretically possible, though I have never heard of it actually happening.

I don't know whether or not I am being too conspiratorial but I seem to be hearing stories lately where the woman has come away from a doctor's visit quite scared and having her confidence in her own body sapped, as if the doctor is trying to scare her into accepting treatment on the doctor's terms, and to expect the worst if she doesn't accept the treatment.

It is hard when you are untrained to tell the difference between genuine concern by the doctor and simply spruiking all the possible complications that they learned in medical school. When we ask a doctor to make medical recommendation for us they understandable have to guard their own reputation by giving you the worst case scenario, knowing that it is unlikely to ever happen, and that relatively the outcome almost certainly will be good, thereby boosting their reputation among potential patients.

On the other hand, maybe they don't think we would want to reach into our own vagina to pull it out, and maybe they don't think right through the concept of a woman (who has had a baby) actually being brave enough to put something in her own vagina. Weird?

Well, you tell me why anyone would spend all those years training to be a gynaecologist, and work in the field all their working life. What sort of person would do it? What is their motivation?

I will leave you to think about these questions.

Louise

We could have no gynaecologist or those that we have-- some will get a sense of the general good and do the job better than others- the one who put the mesh in me is I believe a very interested in the stock market investments kind of person - he is reputed to be good at delivering babies(where God does most of process usually)
This is disappointing - I work on a letter to him and to our medical officer in charge but it is a slow letter, trying to make what point- so far I see only that the surgery was not a success as first reported. thanks Louise for your comments, my mom is progressing good with rehabilitation therapy I think you are right on about the surgeon who removed my mesh - he really made me fear that surgery and it was put off for this reason even though my vagina was a very messy place- when finally over it was labelled a challenging surgery but got the mesh.

First of all I would ask what sort of medical care would create such a job-- there is so much umeployment- someone seeking an income with good academic ability would certainly take this job- I do believe it is a caring medical system that creates this job. I could ramble on..

Say you’ve had bowel problems for quite some time; you’ve recently been experiencing heart irregularities; your blood pressure has been a little high lately; and now you’ve discovered cystocele!

Imagine you make an appointment with the new Whole Woman Clinic that has recently opened in your town. You walk in to a sunlit, clean-air space and are greeted by a cheery receptionist who gives you a carefully blended herbal tea to sip on as you fill out your paperwork.

You are then guided into an exam room for a thorough check-up by a nurse practitioner who also has a doctorate degree in the biological sciences. She asks you about your diet, bowel habits and exercise routine. She is deeply concerned with your emotional well-being and asks probing questions about your interpersonal relationships, your creative outlets, your spiritual beliefs and your fears about loss and death.

She examines you and says yes, you have a mature vagina that is feeling the wear and tear of civilized living. You are told almost every woman your age has some level of the same condition. There is no surgery to fix this, she says, but you will become ever so much more comfortable with time and patience. The postural and exercise efforts she asks you to make she says will become effortless in time and will have far-reaching effects, including bowel and cardiovascular improvements. She sees the signs of post-menopausal vulva breakdown, tells you not to worry, that vulva cancer was one of the most rare of diseases before the 20th century, and assures you that you will become much more comfortable with phytoestrogens, lifestyle changes, and WW salves and vaginal suppositories.

She gives you a copy of the Whole Woman Cookbook, which has shopping lists, nutritional information, sprouting and fermenting guides, and an entire month of delicious recipes. Based on her assessment, she will also suggest certain herbs and a couple of mineral supplements for you to begin taking. You are then given a referral to a local Whole Woman teacher who will provide you with personal instruction in posture and exercise. You will be able to take advantage of Whole Woman Yoga and other creative classes. One evening a week you will also be able to attend Grandmother Circle, where women discuss all aspects of being female and support each other in the Whole Woman Way.

As you are leaving, you’re given a free sample of arugula seeds to toss around your yard and told how easy it is to provide yourself with your very own vital green food.

Keep this vision in your prayers, ladies, as this is where we are headed!

Christine

That is quite a vision, Christine. Even if something like this manages to open up in one or two major cities in my lifetime, it will be a huge step. I hope for much more for the next generation.....access for all women. Personally, to have been one of the luckiest to have the chance to apply this knowledge and these principles and practices to my own life, with the resources and women available here, is an enormous gift.

Wonderful dream,Christine. Remember visualizing it and saying it are the first steps to making it real. Think of the good you'd do for the economy too. All those new careers and jobs!
Whole Woman PA

This is what is needed.. In Ontario, our health care cost is heading for trouble in Greek proportions. Ont government hired a bank official who gave them over 300 cost effective cures, one of which is to take doctors off cases they need not be on. Your essay indicates such an equitable solution. Being a woman who is bewildered by the realization that the surgical solution is a contibutor to the worsening of the prolapse, I am made anxious in feeling that the help is out there to help women live well with prolapse but there is a dangerous dragon surrounding it (gynaecology).

I used to be anxious too, Sammy, but there are so many of us now surrounding the dragon! There was a point in time when we hit "critical mass" that I stopped waking up in the middle of the night in a cold sweat worried that the urogynecology police were knocking at my door. We will do everything by the book and all will be well. It is time for big change and the Angels know it. Thanks so much for being here with us.