Louiseds' POP story

Body: 

I have Pelvic Organ Prolapse (POP) of bladder, rectum and uterus, all of which can come down to the introitus at times, though they normally don’t because of the way I arrange my posture. About 15-20 years ago a gynaecologist told me that my cervix was lower than normal which explained the pelvic congestion I was having at the time. About 5 years ago inability to empty my bowel completely, inability to empty bladder completely, feelings of pressure in my vagina, worsening of stress incontinence, repeated UTI’s and thrush etc took me to a different gynaecologist for a formal diagnosis, as it all seemed to be getting out of control.

Looking back, I suffered from constipation as a child, and did a lot of straining. I also had childhood urge and stress incontinence, so I may have had damaged pelvic supports from childhood. I also learned to stand with my tummy tucked in and my butt tucked under before I finished growing, so that may have inadvertently re-shaped my endopelvic fascia (my theory). This posture was reinforced for over 30 years.

In 1982 I had pre-eclampsia with my first pregnancy, which ended in fully-managed, induced first labour , which culminated in a live me, a healthy baby, a big episiotomy, and a forceps delivery.
In 1984 at the beginning of my second pregnancy I had hyperstimulated ovaries from fertility treatment and my abdomen swelled quickly at the beginning of the pregnancy and for the first trimester, faster than I think my body was able to cope with. I had a very low vulva and very floppy skin on my belly after this pregnancy (which got a bit better but is basically still there), as well as comatose pelvic floor muscles that just would not move at all. These were woken up with several sessions of some sort of electrical stimulation therapy from a physiotherapist, then I could do Kegels again. So I think the second pregnancy contributed to POP as well, though it was an active labour and natural vaginal birth (1985) that was really precious after the trauma of the first.

Fifteen months later, and after only two menstrrual cycles, I became pregnant again. This was unexpected and uneventful and resulted in another active natural vaginal birth (1987).

I remember some pubic symphysis pain somewhere in the past as well, not sure which pregnancy. Maybe four years after that came the diagnosis that my cervix was a bit low. I was getting a lot of pelvic congestion as a part of menstruation. At the first gyno visit described in the first paragraph a pessary was fitted but it was not comfortable and wouldn't stay in position properly after a couple of months, so I ditched it in the back of the bathroom cupboard and decided to just take it a bit easier on the first couple of days of menstruation instead. This was about 1991.

A few years after that I realised that my pelvic organs were no longer flopping.

2002 I was diagnosed with asthma which I had suffered from, undiagnosed, after respiratory viruses, since childhood, and which was steadily worsening my prolapses, which is what led me to the gynaecologist.

Mid 2003 my marriage was in bad shape and I was under a great deal of stress with resultant adrenalin and constipation which worsened the bowel symptoms, as I would get stool stuck in the rectum and couldn't shift it. I discovered how to splint when emptying my bowel. It only helped with emptying, not with the constipation, which I think was caused by my my body being constantly in stress, and moving fluids to my 'fight or flee' tools, being heart, lungs, arms and legs, and away from my digestive system, compounded by the asthma.

I moved out of my marriage of 25 years, and my home, at the end of 2003, and did a lot more heavy lifting and carrying than I should have, which worsened my POP again.

Then my husband and I then experienced a miraculous reconciliation and I moved back in again within six months! More heavy lifting to move back in. More prolapse. I managed to kick the asthma around the end of 2004by learning Buteyko breathing, and this improved my bulging vulva and the stress incontinence to a great degree, as I was no longer having bouts of coughing that strained my pelvic floor viciously and continually.

In mid-2004 I found Wholewoman just prior to the gynaecologist visit. He told me I had rectocele and cystocele, and that he would remove my healthy uterus so he could hang my bladder on the stumps of the ligaments remaining, and put a tape under my urethra to support it. I had been implementing WW posture for a few weeks by then, and could see the difference it was making. So I said no thankyou and showed him the first edition of Christine's book. He smiled wryly and said he would probably see me for an operation at some time in the future. I have never been back and see no reason why I would need to, unless menopause causes some problems. I still have a few aces up my sleeve if things worsen, as I do not exercise regularly enough, and I have not tried Alemama's nauli or firebreathing, or support garments. I feel pretty confident about managing any difficulties in the future. BTW, ion Australia we see a general practitioner or nurse practitioner for annual PAP smears.

Anyway, I have diverged. Probably early 2007 I was doing some pretty strenuous garden and demolition work at home, and realised that my previously off-centre cervix had centred itself and was now lower. However all was not lost, as this meant less rubbing on one side of my vagina. The rectocele then ceased to bother me, being held back by my descending uterus. This is what Christine calls nature's pessary; all the organs coming down, and together, blocking the exit for any of them. I was actually more comfortable with them all lower than I had been for years.

Since then, I have only been bothered by my rectocele occasionally, and my cystocele is just there, with my cervix about mostly about 1cm inside the introitus, and recently less, only detectable before menstruation, and occasionally for a couple of days if I overdo things. I really wouldn't even know I had POP 90% of the time, and I know that if my organs descend they will rise again in a couple of days or sooner. I have new faith in my body. I also have very little stress incontinence and urge incontinence - better than ever. I went for a 15 minute jog/walk the other morning with no leaking at all, and I now never wear pads, except for menstruation.

Mind you, I use WW posture all my waking hours, rarely lean against the back of a seat, except in the car where I have modified my seating with a wedge under my butt and a small lumbar support. I eat a diet rich in veges/salads, fruit, raw nuts and seeds, mostly whole grains, some meat, fish, eggs and other proteins including dairy, pulses, mono and polyunsaturated oils, but I also allow myself treats like expensive chocolate in very small quantities, and good cake and bikkies in moderation. I drink a cup of good coffee most days, and black, green and herbal teas. A glass of wine at night. Don't touch softdrinks and fruit juices. I don't eat takeaways and other highly processed foods more than twice(?) a month. I do bellydancing once a week, do gardening, housework, handyperson and farm work, and other lifestyle activities like parking a distance from my destination and walking, use stairs instead of lifts, etc. I sometimes do Christine's ballet workout. DH and I dance socially on occasions, latin and ballroom. We have just started Swing Dancing as well. I wear only clothes that do not compress my belly, and mostly go barefoot or wear thong type shoes so my toes can spread. You can do a lot with toenail polish! ;-)

I am pretty comfortable with having a mature woman's body and a belly which has a structural function as a place my pelvic organs live. I am way more comfortable about the appearance of my middle-aged body than I ever was as a young woman. I certainly feel more feminine than I have ever felt. I probably wear sexier clothes, definitely have a better sex life and relationship with DH than I have ever had before, and have cast off the fear of my organs descending because I know they are safely supported by my natural body structure, which I have at last learned how to 'wear' and use properly.

I am thankful for this body which has borne and fed three lovely children and gives me so much enjoyment, in spite of a few aches and pains for various reasons. I am not scared of it, and I hope will be able to adjust to its gradual decline in old age, without having to deal with the internal scars from surgery and still having my uterus, that I believe are important for whole of life. My body is my good friend, to the end. This is probably just me getting older and wiser, but I think that the whole prolapse experience has been a catalyst and an awareness raiser for me.

Louise, 22 June 2008

I obviously haven't read enough of this site to know what's going on. Having just read Louise's story I am vastly enoucourged to believe that there is betterment (is that word?) for POP. I thought once you had it, that was it. Although it's not going to go away, I now realise one's quality of life can be greatly impoved.

Because of exchange rate/shipping Christine's publications are expesnive for me but I think I'm going to bite the bullet and buy the video. It's time I took charge of this POP.

Sally

especially if you are a visual learner...
So glad you are learning that you don't just have to live with it.

I read Louise's post before, but I was glad to read it again. Louise mentioned she had been doing the posture for a few weeks and was noticing a change. That really makes me feel defeated. I have been doing the posture and some of the exercises for 3 1/2 months and have not noticed any change. If anything, I think my bulge is getting bigger and lower. I never have a day when it doesn't fill my vaginal completely and protrude beyond my vaginal opening. Am I just too far gone for this work, or was anyone else's prolapse this bad too? Sorry to be such a downer, but I am scared and can't figure out why I am not showing even the slightest improvement. Connie

Hi Connie

Every woman has a different body and different POP's. Yours may not behave like mine. My pelvis was previously tipped so far back with butt and tummy tucking, it wasn't funny! However, having said that, let's go back to the beginning.

Do you have Christine's book, second edition?

Do you have the new version of the DVD?

As you are having real difficulty with your POPs I really think these two resources are key components of finding out what is happening with your body. Without the book you cannot fully understand the anatomical theory of the pelvic cavity, which is quite different from the normal description of the female pelvis that you get from medical texts. There is lots of other good stuff in the book too.

As Alemama pointed out, the DVD can teach you what to do about it *visually*. After four years of WW work, even I had a couple of Aha! moments when I first viewed it a few weeks ago.

It may seem like a big initial cost for the two items, but it is realy an investment in the integrity of your body, enabling you to avoid the costs (both physical and monetary) of surgery).

Don't worry, we will not give up on you.

Cheers

Louise

Thank you alemama. It's so good to be able to talk to people who understand. I hope we'll all be able to fine peace of mind, if not peace of POP. The yoga philosophy teaches that you are not your body.......and a jolly good job too! Wishing everyone a day with some peace and pleasure in it.
Sally

Hey, Louise,

Thanks for sharing your story, it was encouraging to me! I have one question, what did you mean when you wrote this?

A few years after that I realised that my pelvic organs were no longer flopping.

Maybe it is just my poor english, but I don't get the flopping POs. Please, elaborate if you have time! lol
Thanks! :)

Liv

Hi Liv

What I mean is that for some time after having babies I felt like everything in my abdomen and pelvic cavities would kind of slosh around like a half full barrel of water when I ran or danced. I kind of got used to it, and didn't do a lot of running or dancing for some time, but I realised one day a few years after the birth of my third baby that I no longer felt like all my organs were flopping around on the loose in there, and I could comfortably run again. My insides had all tightened up again without my noticing. Probably the outside had tightened up a bit too. It is not as tight as it was when I was a teenager, but I don't feel like a half full barrel any more. My youngest has just turned 22, so it is a while ago now.

Cheers

Louise

This is clear now! This is exactly what I am experiencing right now. It is only my bladder and urethra (yet, lol). Good to know that this can get better, or go away.
I believe, the fascia and ligaments, tendons can stretch and then shrink back. For exapmple if we stretch our muscles and tendons, they would be looser, laxer (cool thing for ballerinas). If we provide them time to rest and with the good posture we do not stretch the PO ligaments any further, they can firm and shrink back. This firming is not good in our muscles, but a good thing in our PO ligaments.

Am I right or not? If not somebody please open my eyes!

Liv

Hi Louise, international bottom-guru (did you ever think you'd one day be known as this??!)

I posted last week about my ongoing rectocele angst, paranoia about making it worse, discomfort from feeling full all the time and assorted other gripes and whines. After a couple of somewhat improved days last week, we're now back into the territory of mild tummy upset especially after eating, up to 3 morning/early afternoon BMs, each increasingly loose and difficult to expel, and continual feeling of rectal fullness.

I feel I need to find a way of taking the strain and the mental pain out of the toilet routine. The first morning one, as for many other rectocele ladies, is usually substantial and, if not complete, then almost complete (though this morning was a bit less so, and I'm trying to not to work myself up into a lather about that). It's the rest of the day that's the problem - even if I end up managing to go a couple of further times, it seems nature abhors a vacuum and invariably, some more stool moves down to take its place within 30mins - 2 hrs.

So, I'm considering trying enemas later on in the day, rather than endeavouring to shift out through splinting and internal peristalsis (I always splint and I've now got the hang of half-squatting so am not straining against the toilet seat, but I still think I'm straining in some ways). Especially just now when I'm still trying to create as much of a healing environment for the rectocele as I can.

I've been looking back through old posts to find out about people's experience but it seems very mixed. I know you're not an enema user yourself, but you seem to have a very good understanding of bowels and their foibles, and I wonder what your take on the relative risks and benefits are. I've got this horrendous vision of trying an enema and discovering a) that it doesn't work and b) that it's bulked out my rectocele pouch and c) I can't shift it, but equally am trapped at at bursting point in the house with the baby. (Catastrophiser - moi?)

The GP prescribed me some micra-lax which are a kind of mini-enema. Are these straightforward and safe for rectocele use?
I've considered a full-on old-fashioned enema kit but I can't see how I could pump that amount of water into my rectum without stretching the rectocele at teh same time. Am I missing something?
I've also looked into the rectal irrigation thing. This was subject of postings last summer by Pam from the UK. don't know if anyone else has tried it here. (incidentally, I found the research paper looking at use in rectocele and it's pretty encouraging about the results
http://www.redorbit.com/news/display/?id=106018

Set against all this is the fact that I've also been advised that with time, one can get used to the bowel full feeling and it stops being such an irritant. I'm mindful that if I use enemas to clear out any stool that's moved into the lower rectum (which can happen more than once in the afternoon/evening), then I'm not going to get used to the feeling, and conversely may make my rectum even more sensitive to it, so that it becomes more of a niggle not less (much as you can make your bladder over-sensitive by going to often).

But I need to find some kind of relief from it. It's got to the point that I frequently dread evenings and am turning down social invitations just at the point postpartum that I should be taking them up eagerly, and find myself uncomfortable and distracted from about 2pm onwards; and I still dread eating because I know that there's likely to be some stool movement into the rectum afterwards. Oh, and still no chance at all of sex because of the the continual stool blockage feeling.

My No 1 fear in all of this is making the rectocele worse.

Basically, my bottom is making me mental!

any advice appreciated and apols for the endless qus etc

Mumtogirls London

Hi Liv

I don't think it is quite as simple as that. There is a hormone called relaxin that has a function during pregnancy in loosening ligaments, but I am not sure about what happens with relaxin production after the birth. Yes, the tissues do stretch, then shrink back, a bit like a balloon after it is deflated. Sure, balloons are dead, but people are alive. Ballerinas may have looser ligaments and muscles and tendons, but these same tissues are very fit and resiliant, probably *much* more so than the average postpartum Mum's tummy. Stretching the 3-D network , so it is bigger but thinner, is one thing, but straining it to a point where the fibres start to come apart and cannot recover spontaneously is a different matter altogether. If these tissues are broken or cut they can be stitched back together again, but healing is often imperfect and they are left like a t-shirt that has been mended. The bit where the mend is goes all puckered, and may hole or run again if stretched, or stitches may be missed and it may hole anyway. I am not quite sure about the effect of suturing, whether scar tissue forms and joins the tissues together again, or whether the close sutures literally bond the surfaces together again. Hopefully somebody more knowledgable than I am will chime in and put us both right.

Cheers

Louise

Hey Louise,

I guess I need to re-read my anatomy books and atlases. :) Anyway, you should be right, I totally oversimplified it...
Liv

I think they all respond differently to overstretching. pretty sure that an overstretched tendon, as long as it isn't torn or stitched or otherwise compromised, will go back to original size if given the right set of circumstances.
pretty sure an overstretched ligament won't. which is why once you sprain your ankle, you are prone to further sprains. a PT would advise you to strenghten the ankle musculature to compensate for ligamentous instability.
never really understood how relaxin works, though I've felt its effects! I've always wondered why the ligaments become lax and why they tighten up after pg.
dont know about fascia, thinking fascia is probably more similar to ligament than tendon. but in my visual, as long as the fascia isn't cut or stitched, I can pull up the excess in a place where I was previously not using as much as was needed and thereby tighten it up. so in my mind, by pulling up into WW posture, I'm pulling the extra fascia from my pelvis up into my shoulder girdle and spreading it out over there. have no idea if this is really how it works, but it makes me happy thinking about it this way.

I think you are right Gmom. The visualisation is handy too. L

Louise story is a good testimony and reading for all women managing prolapse with whole woman. How spectacular that she became more comfortable after employing whole woman posture even when her organs were settled fairly low in her pelvis. Interestingly she said she was more comfortable than she had been in years even with the cervix settled lower after it fell more. Also it’s notewirthy that she said Andrenaline surges from extreme stress contritbued to her constipation. I have found the same to be true for me. It’s just that post prolapse the discomfort from this is greater. But without whole woman posture and other means there was less hope and less ways to manage, and the organs all being crammed in the back of my pelvis made it so painful and hard to even pass gas. I am thankful for this website. I hope that others will see this story and read it.

It has been a while since being here and thought I would log in and say Hi to everybody.

Can't believe my child is about to be 16 this year so that says I have been a member for a very long time.
Nothing much happening - Poppy - As I call her made an appearance today... A reminder which tells me to buck my ideas up - and check my posture etc.. Hopefully it will be just a blip that happens every few years :-) Guess I am getting older and new challenges are on the horizon maybe.. :-)

I noticed no IMs here any more... Unless I missed that...

I do hope everyone is doing well...

Hi and thanks for checking in! Yes, lots of changes on the site, but the message is always the same. These little blips happen to us all, and it's a good reminder that the WW work is ongoing and our symptoms are always lurking there waiting to nudge us when we aren't paying attention. Keep in touch - we are always here! - Surviving

Hi Surviving. Glad to see people that I remember here - As you say - A nudge is a great reminder, even if only for a day it reminds you to keep in check :-)

hi memyselfandi - I'm new-ish here but I have to say your name has popped up as I read and read through this wonderful forum. I thought I'd say hi - from new member to long term member. I'm glad you've popped back in and it seems like your prolapse is still well controlled after many years? That's always heartening to hear to those of us who have been on this path for a short time and wonder what the future holds...

Hi Typicalme..... And welcome to the family that is Whole Woman

I have had my prolapse for *thinks* That I know 100% about from my third child which is 15.5yrs ago now and I came here when she was about 2 or 3 but - After I had my first child I felt like I was gonna give birth to a brick afterwards - He was a forceps birth and that is where all this damage began I feel.....

When I came here I was a MESS. Emotionally and physically. This POP thing really does emotionally make you feel battered and bruised and like you have lost yourself. I felt like your body had failed you and would never ever be 'normal' again and I would always have to pussyfoot around that which I now call POPpy....

Now - All these years later I am on 95% of days perfectly fine. Obviously I do not know what the future will bring but nobody does. Every now and then I have a blip and you return to where you know you will get sensible advice.

But the truth is - You CAN live well with prolapse. It takes work and a mindset that means you are adamant you will not give in to the Doctors who want to 'help' you with 'a little operation' Which I am obviously not wanting and will do anything and everything in my power to stay away from lol.

I am feeling fine now - I know the great menopause is not so far in my future an I am pretty sure that will send some obstacles my way.....

Just know that if someone as messed up in the head as I was can do this - You can too! The people who were here when I got here (and at the time when everything went down hill for a while not long after) They will know that I was desperate - emotional - scared - so many feelings that were all rolled in to the fact that I felt I would never be normal and would never cope - And look at me now! What is it now - 12 years and more later... And I am still living. still doing many of the things I want to do - Yeah I don't go out weight lifting - But then again I never did... LOL.... We plod along and we take a few steps backwards every now and then - We learn from that - And on we go :-)

I do hope that you will find much care and help on here - I know they gave me back my whole life in so many ways - And I may go off for a while but I always remember and return..... If only to say Hi :-)