Postparum Prolapse = Depression

Submitted by BSMrunner on October 9, 2009 - 5:29pm
Body: 

This is the first time I have been able to log onto this web page, for some reason I never got a password. I have read some threads on this forum in the last months and I always end up crying. I really need some support along with advice and information. I hope to find it here.

I am a marathon runner.
I am a whitewater rafting guide.
I played college soccer.
I love to backpack.
I am a physical therapist.
I am one of the most active people I know.

I am 8 months postpartum after the birth of my first child and I have had a prolapse for 4 months. This is what happened to me....

I had the most amazing birth experience: 17 hours of labor, 1 hour of pushing, natural delivery in the quadruped position, no tares, no drugs and a healthy 8lb 12oz baby boy. I couldn't wait to start running again but every time I tried, it just didn't feel right. I thought I had a strained psoas muscle because I had a deep ache on the right side of my abdomen and I had low back pain but I could never stretch it or recreate the feeling. All of my symptoms I associated with just giving birth. I laid off doing a lot of activity. I probably had a really mild prolapse but then on June 11th I was jumping around the living room with my son vigorously! and felt something DROP in my vagina! I knew this was bad. I went up stairs and looked to find a bulge inside my vagina.
After 3 phone calls to my OB's office they got me in the next day. When I saw my OB she said I had a cystocele and pelvic relaxation, she pretty much blew me off and told me I would be fine. I started physical therapy the next week and a month after this happened I went on vaginal estrogen cream.

Well my life will be forever changed. I can not tell you how devastating this has been for me. I cry A LOT! I am the happiest and saddest I have ever been in my life simultaneously. The dichotomy is difficult to navigate. I want to run and jump with my son, I want to take him backpacking, I want to run races with him...
I am petrified to move! I can not run, I can not lift things...I can't be who I am!
I hate that if I had only known what was happening I could have avoided making this such an extensive injury. I feel like I should have known what was going on. My OB says I am the most athletic person she has ever treated with this condition and says her other patients were not as affected by the injury. I don't buy that for a second. I think I also don't hook line and sinker everything she says and I know the ramifications of such an injury.

I am grieving for the loss I have sustained and I also keep thinking I must find a way to recover. I just HAVE to get better. I believe I have a rectocele as well which my physical therapist pointed out and I believe I have one also based on symptoms which I am trying to manage with diet. My OB thinks I have good tone on the posterior wall of my vagina hmmmm. How do I get through this, I try to avoid the "Why Me" thoughts but they slip in anyway. I have improved in the last 3 months. My OB says now my bladder does not come to the opening of my vagina when I bear down and I can pick up my son on most days without feeling like my guts are going to fall out. I feel like I am 33 going on 80.

Some questions I have:
1.My PT thinks it may be a good idea to use a pessary. I am concerned that putting stretch on already pathologically thinned tissue may make the injury worse. At the same time with any ligamentous injury (for example a knee) even with good dynamic muscular stability you still wear a brace to keep the structures in place while they heal. Should I wear a pessary to help the bladder heal in the correct position?

2. How long is considered prolonged use of vaginal estrogen cream? I think it has helped but I am still breastfeeding. I would have breastfed my baby until he was 2 years old but now I feel like I should give my body the best chance to heal by regaining my normal hormonal levels which happens 6-8 weeks after weening. Breastfeeding is an integral part of me being a mother. I feel very connected to continuing. Any advice?

3. I am going to start counseling next week. I think this is better than going on medication for depression. I usually cry every 2 weeks but with my recent visit to my OB she told me "this may be as good as you are going to get" How could she go from "you'll be fine" to "this is it" in 3 months. Ligamentous injuries can take 6 months to a year to heal. How can she cut me off so early? so I have been really sad this last week. Does anyone have advice for keeping spirits up. I want to be positive and believe I will continue to heal. I don't want this to rob me of the beauty and love of having a new baby.

4. I know this is early but...if I want to have another baby... I know you can but I am just wondering if I should have a c-section so I don't cause further vaginal damage and prolapse. So weird that should even be a thought. The ONE thing I wanted to avoid with my first birth was a cesarean. I TRAINED for my birth so I could do it all naturally...who knew I may have been able to avoid this injury if I had gotten the one thing I was trying to avoid. You know the saying "you may meet your destiny on the road you take to avoid it" Any advice on second births?

Okay I think I have said a ton...I hope to find some encouragement and advice among you all. I feel like I could type for hours about how I feel, "what if" and "how come" SIGH! I will get better, I will get better, I will get better. I will be a success story, I just have to be!

Thank you for reading...

BSMrunner

October 9, 2009 - 6:17pm

sorry I didn't know not to post here. I posted in pregnancy and prolapse also. It will take me a minute to figure out how to get around the web site.
~ :)

davemayamom

October 9, 2009 - 7:40pm

Hi BSMrunner,

This has got to be quick as I've got limited time but I thought I'd try to throw you a lifeline. I too have an 8 month old. I discovered my prolapse during my pregancy with her - eary in the second trimester. I noticed a bulge in my vagina that was misdiagnosed by two GPs as a vaginal varicose vein; really it was my urethra protruding into my vagina. To make a long story short, I had a rough pregnancy - lots of pressure, a lovely natural birth, and I felt tonnes better with the weight off. I still had feelings of heaviness and, yes, tissue still at the entrance of my vagina, but it slowly got (and still is) getting better. My bulge is getting smaller, and I only get some irritation and some saggy feelings if I jog (not distance, just after my older son). I really believe it will keep getting better (not to say I don't have my down days).....Oh, and yes I am/was active, I am also a physical therapist, I am 33 like you, and yes I was ticked off. These forums offer you way more support and healing strategies than most doctors and pelvic floor P.T.s. Most moms in this forum that have prolapse ARE also active and have gone on to birth other babies and have healed again! Read posts by: Alemama, Granolamom, Kiki, Badmirror, Lyricmama, Canadianmama (her 17 months pp update was very uplifting), Clavicula, Phoebe9 etc. It WILL continue to get better.....Learn the posture, wear loose clothing around your midsection, eat well, and don't strain on the toilet. If you can, buy the book and DVD. The workout isn't quite what you are used to as far as exercise, but it takes stamina!

Relax and enjoy your little one, keep reading, and keep us updated.

Take care,
Janice

PA runner

October 10, 2009 - 9:03am

Your post reflects exactly how I felt after the birth of my first child, a non-traumatic, non-medicated, midwife delivery in a hospital. In the year before I got pregnant I ran two marathons and completed a couple triathlons. Please read my posts and ask any questions you may have regarding exercise and prolapse. I have learned to be aware of the prolapse but not obsess. This took several years and allowing myself to grieve. My initial goal was stabilization and then a return to the activities that I love. I went on to have a second child which did not result in any significant worsening of the prolapse. Most of the time I would say no worsening, during the rare instances when my prolapse is symptomatic I do wonder but I overall feel that this is where I would be irregardless of the second birth. I haven't run another marathon since the kids but I am hopeful. It has been a time issue and a foot injury not the prolapse. I lift weights (free weights) and do some moderate ab work in WW posture. My current long runs are 8 or 9 miles with weekly mileage in the low 20's.

Good Luck!

bad_mirror

October 10, 2009 - 7:32pm

Oh BSMrunner, this whole thing is crazy, ain't it? I think you are right to start the counseling. PPD is a very real thing and very much compounded by POP, don't I know it! I too was very in shape/healthy -- was a professional ballerina. I had a totally awesome, 100% intervention-free home water birth. Wow, can I relate to the "why me?"!!! At 11 months pp, I am almost past that. Dealing with prolapse is a grieving process, for sure. Allow yourself to acknowledge that, but know that, as in every grieving process, you WILL move to another level. I am confident that you will do everything you used to do. You WILL!!! Get the DVD and the book. The postures, sitting and standing, feel good, are "free" therapy and really do work. I kid you not, I get at least two compliments a day on my "beautiful posture!"

So let's take a deep breath together here. You say you have improved in the last three months. And you will continue to improve. I would suggest getting a sea sponge tampon to use as a pessary, if you feel the need for support. I used one often in months 3-6 pp, but rarely now as I feel pretty darn good w/o it. I do use it for my 12 hour shifts as a nursing student, but could probably do without. It's cheap, and closely approximates vaginal tissue. It will allow your vagina to come closest to it's natural closed state, as it flattens while still providing support.

Breastfeed as long as you want! Most women report worsened prolapse symptoms with their period, so why hurry your cycle back? (Or if your cycle is back already, your estrogen levels are normal, so stopping BF wouldn't make a difference anyway). I can't advise on the estrogen cream. Personally, I'd ditch it. Your body was made to birth and feed a baby. There's not an expiration date on healing. Many women here who are not pp have been able to reverse their prolapses.

Doctors are great, but they don't know everything! (Boy if I had the time, I'd relay an amazing story about why it is soooo important to get a second opinion!)

A few members here have actually contributed their prolapses to C-section. As you know, it's not ideal for you or your baby, and really, cutting through the supports of the bladder and uterus does nothing to prevent POP, kwim?

If you have the time, read every post on this forum. You will see several women who have had 2 or more babies post prolapse and do whatever they want, activity-wise!

Hugs to you. Ask whatever you want. Do the posture! BTW, I've found walking in the WW posture to help tremendously. Put your boy in the stroller and start enjoying the rest of this glorious autumn! It will help your body and your mind. I promise.

Sorry this is rather disjointed and hurried -- juggling a baby, husband, dinner, and nursing school homework ahhhh! But welcome. :-)

mzimm

October 11, 2009 - 1:04am

Hello! First of all, I wanted to say to BSMrunner that I am right there with you! I was training for a marathon when I got pregnant and just thought, "Oh well, as soon as the baby's born I can always train for another one." Boy, have things changed! I was ecstatic last week because I ran my first postpartum mile. But then I was too scared to do it again because I don't want to make things worse!

Anyway, I have a few questions for you PA runner. When did you begin running again after your babies? Do you run on a treadmill, trails, or concrete? How did you monitor whether or not it was making things worse? Do you feel any different "down there" when you run? I felt great when I was running, but it does feel different than it used to--no pressure or anything, just a bit saggy. Is that worrisome or to be expected? I am SO ready to get running again, but SOOOOO scared of making things worse!

Thanks so much!
mzimm