Enlightened Doctor in UK - or even France

Submitted by doubtful on September 23, 2010 - 7:20am
Body: 

Has anyone in the UK come across an enlightened or at least openmined doctor/ therapist- a gyneacologist, GP or even a physiotherapist (p.t.) ? By enlightened, I mean someone who is taking on board postural/ non surgical approaches to prolapse or is at least open minded and interested to hear about new approaches. I'd also be interested in anyone who's really good/ expert with advising on or fitting pessaries.

I'm 46. Two straightforward vaginal births fifteen and nine years ago - but both babies had massive heads . I've got what my GP says is a minor urethrocele - not a bulge - just a little fold of skin that I first noticed during my second pregnancy but is now just beginning to droop outside say 1/2 centimetre when I'm standing up. I don't have any associated symptoms and I can't feel it ( unless I feel it with my fingers) but if doesn't feel 'minor' to me -bearing in mind where it is!

I'm doing the posture/ sponges like mad but would like some medical validation. I took my copy of Christine's book to my GP appointment and she said she was proud to say that she had never heard of it and wasn't interested. She's all for surgery or do nothing - either that or one of three ring pessaries: small- medium or large. She says every woman fits one of those and she has an unqualified teenage healthcare assisstant that she's training to fit them. As you can imagine, I wasn't tempted - and she said I couldn't have one anyway as she wouldn't recommend a pessary for my problem and 'theyre only for old ladies long term anyway'! And she's the woman's health GP specialist in quite a big town! Having had truly appalling experiences with some of the local gynaecologists during 'at risk' pregnancies and when I first noticed my 'fold' - ( way back when it hadn't dared to peep out) - I'm prepared to pay to go privately and travel anywhere in the UK to see someone else.

I know Christine's work is endorsed by the world famous French obstetrician Michel Odent and that he's based in London now. I'm sure he's too famous to be practising as a clinician, but does he maybe have a following of likeminded younger gyneacologists?

Anyway - a long shot but a cry from the heart to all my fellow POP women in Britain. I don't know if there are any members in France - but |'m bilingual and travel there a lot - so any leads there would be great too.

kiki

September 23, 2010 - 2:44pm

HI Doubtful,
I am sorry you got this response! Not encouraging...

My first question is what do you want from a doctor? If you want someone to fit a pessary, there are many who can do it. But if you want someone to say "yes, you have a prolapse and the postural work is the answer" we'll have to look harder... Most doctors just aren't there yet. From what you say, you've been diagnosed, and you have no symptoms, so you only know about it if you go looking for it. I bet a lot of women fall into this category, and just don't know they have a POP. I am wondering what you are wanting a pessary for if you have no symptoms? I'm not against pessaries, but they do hold the vagina open in an unnatural position, and aren't going to heal your body. In my mind they are best reserved for if you really need them to improve symptoms.

I'm int eh UK. I saw a major urogyn who was, from the sounds of it, alternative in that he advocates surgery as a last resort. But he wasn't going to start looking at posture. He sent me to a physio who can definitely fit a pessary, but her "tool" is pelvic floor work. I didn't get the sense she was open to much more--when i talked about posture she talked about pilates helping...she was lovely and really helped my emotional state, but i'm not sure she was ready for WW.

So, I'm afraid I don't have an answer, but first I think it's worth looking at what you want and go from there.
if you want either details then click on my name and email me from there and i'm happy to share them...

How long have you been doing the posture for? REmember it takes time. the POP didn't happen overnight, and won't reverse overnight. But that isn't to say that this doesn't work. Are you doing any of the excercises, ie the DVD / book routine, nauli, firebreathing? i found diet to be very key, and anti inflammatory eating really helped (there are long threads about that if you search). so there is alot that can help, but it can take time as we have years of how we carry our bodies to undo.

Kiki

MeMyselfAndI

September 23, 2010 - 2:45pm

I thought I had found someone who wouldn't push into anything - And in most aspects he didn't he said 'used a tampon' and I did for a while - Though not the way he wanted it used (I used it sideways) I had seen my GP who put a pesary into me - This gyno said it was way too big (It stayed in me 18hrs then I removed it and I am glad I did - Couldn't go to the loo)

Then after a while he kept mentioning 'a little operation' that would fix all ills. I knew at that moment I wouldn't be seeing him again. Although my Mother has her Pessary fitted by the same man and she says he is great - He knows she will not have any operation and - As she pays privately - He does what she asks of him.

A while ago I had a 'peeking POP' and it was annoying - But after a year of posture and maybe even the support of the sideways tampon helped my body to realign itself - Who knows - I know now that I do not have to wear a tampon or a sponge or anything for support any more - It is no longer peeking - And normal life resumed :-)

He is apparently the chief gybo type bod in the Kent area though - He works in our NHS and Privately. (If you go NHS though you would possibly be seen by one of his team) I had to ask to be checked standing up as they seem to like it lying down...

I think that - If you arm yourself with the knowledge, and you can accept that your body is forever changed - Then POP can become your friend in a way (OK not best friends but you know what I mean)

I hope that you find the person you are looking for :-)

MeMyselfAndI

September 23, 2010 - 2:49pm

For some reason I cannot edit. Just wanted to say - That Posture will be the thing that needs the most focus..... No gyno is going to 100% agree with Christines work. Not that I have heard of in Uk anyways

I feel that most Doctors are kinda textbook and aren't open to that which they didn't get taught in medical school.

That needs to change! And we - As women - Need to change that.

Good luck
x

Christine

September 23, 2010 - 3:45pm

Will check on it! :)

doubtful

September 24, 2010 - 7:56am

Thanks Kiki and everyone for replying so promptly and thoughtfully.

Basically, I accept that I don't have a big problem at the moment, but a potential one that I want to do everything I can to stabilise or ( secret hope) reverse a bit. My GP saw me off with the words "come back when it's worse - leave it too long and it will stretch too much for a good surgical result". I think this is all our fear - that things are going to get worse and we want to be as sure as we can do that we are taking the right( non-surgical) steps to help ourselves. Yes, we have to accept that our bodies have changed, but we all want to get our lives and bodies as nearly normal and active as we can.

I'm interested in a doctor who's a pessary expert ( my local expert clearly isn't) because recent medical studies have suggested they can actually reduce the size of anterior wall prolapses over time. On the other hand, I can follow the logic of Christine's suggestions about why they might make things worse for some women. It's interesting that this isn't mentioned in any of the medical studies I have found on the net, or in the rather patronising 'information for women' produced by hospitals/ clinincs. Indeed they seem to be promoting pessaries now in the UK with doctors more openly discussing how the surgical option may cause more problems than it's worth with women's increasing lifespans and the need for repeat surgery. Perhaps there's less of a financial incentive for gynaecologists to recommend surgery here as it costs the NHS a lot and pessaries are cheap. I wonder if it's the US gynaecologists or the UK ones ( or both) who might be influenced by financial considerations here. I'd also like some expert advice on whether pessaries can help someone like me with a localised POP right by the entrance.

I 'd also like some ideas ( from doctors or WW experts) about the long term effects of using a sponge or tampon. In the past month since I notice my POP I've been using a very cut down sponge religiously - I cut it until it's the size of one of those short tampons that expand widthwise. I push it in just so far that it gently flattens my llittle POP back against the inside. I don't need it for comfort, but it reassures me that it's fighting back against the forces of gravity as I go about my active life ( in the posture as much as I can) , and at the very least buying me time. It's encouraging to read posts from a few women who said they used these for a while but then didn't feel they needed them any more. Long term, could they encourage a little urethrecole to shrink back, flatten and behave itself? Conversely, could they in any way make things worse?To work for such a low lying POP they have to stay at and just above the introitus. I suppose I have the same question about tampons worn down there, a bit lower than I would without a POP.

Christine

September 24, 2010 - 10:48am

Hi Doubtful,

I talk to women all the time who received the exact same treatment from their doctors. Their responses are often similar...”I just got out of there as quickly as I could!” Isn’t it time we call or write letters to these people telling them about the narrowness of their treatment protocol?

I love reading old surgery textbooks - before the days of the internet - when no one but the profession of gynecology had this information. Not only are they condescending and often demeaning, but give a very clear picture of the fallacy of the surgical “cure”. Nichols and Randall were some of the most respected and really set the surgical standard for the latter part of the 20th century. When I hear the words of doctors like yours I can see the “purity” of their education and influence. Here is how N&R teach how the pessary should be used - or rather not used.

“When symptoms are relieved by the use of the pessary, the gynecologist should be prepared to resist the patient’s request for reinsertion of the pessary as a substitute for the indicated surgery. She should be advised that the pessary is only palliative, not curative, and acts by continuing a stretch in the opposite direction of tissues that have already been pathologically elongated. Silent progression of the prolapse and widening of the levator hiatus usually will continue until a pessary can no longer be retained. At that time, the now older patient will be a less favorable operative risk, and with fewer remaining years in which to enjoy the comfort that surgery should provide.” Gotta love the “should provide” - lol.

There is no question that their drive is toward surgery. However, were they really seeing this “silent progression”? I think probably so - but not because of stretching of vaginal tissues. The vagina can stretch beyond anything a pessary might cause and be none the worse for it. However, nature closes the vagina completely under intraabdominal pressure. It is holding open of the walls that must therefore be questioned.

I can offer the recent words of our member, Judy, who was really benefitting from use of tampons for a period of time. However, “I wore the stupid tampon for two years until my body finally screamed NO NO NO!!! So, I sighed and went without. I still use the posture faithfully, and you know what? I'm fine. I rarely even think about it.”

Every woman needs to work this puzzle out for herself. Any sort of pessary will only reduce symptoms by pushing bulges out of the vaginal space. They will not draw the organs forward toward their natural positions. Only posture and breath can do that.

Christine

BSMrunner

September 24, 2010 - 11:09pm

Hi...I just wanted to let you know that when I saw a Urogyno he recommended I not use a pessary at all and not to get surgery. I asked about Pessaries making the prolapse worse because I had heard that using one for a while as the ligaments return to there shortened position can be beneficial during the healing process. He said that the space occupying pessaries can stretch the tissues out and make them worse but the kind that make a seal above the pubic bone dont make the prolapse worse. I did not get a further explanation because I was not being fitted for one but I hope that helps some. I think using one for a while might not be a bad idea, kind of like a splint for a injured ligament elsewhere in the body for a little while. Just my opinion.

louiseds

September 25, 2010 - 12:55am

Hi Doubtful

Interesting username. Maybe one day you will, like me, cast your doubts and fears to the wind.

I can only reiterate Christine's last sentences. "Every woman needs to work this puzzle out for herself. Any sort of pessary will only reduce symptoms by pushing bulges out of the vaginal space. They will not draw the organs forward toward their natural positions. Only posture and breath can do that."

The posture works, only because it slides the organs forwards, so they are mainly resting on bone, not thin, sinewy muscles. Without adjusting your posture 24/7 your organs will not be supported on a firm base, and yes, I imagine that your doctor's prediction could come true. My doctor made the same prediction about 6 years ago, when I first learned WW posture, and it has not come true.

Fear is a strong motivator for surgery. Only when you have lost your fear will you be able to make a rational decision. The irony is that once you have lost the fear, there is little point in thinking about surgery. ;-)

It may take quite some time, and takes some effort at first, but eventually your body will know it is out of posture and will cue you to stand tall again.

Louise

doubtful

September 28, 2010 - 4:15am

Hi Christine

Having a bit of a depressing few days. I thought about your comment about tampons, and I'm probably going to stop using the wide ones for my period. Yes, they do suppport the bulge but they are quite hard, not comfortable so instinctively I thought they might not be a good idea. I've always used the long slim ones before this month ( pre prolapse crisis) and they're perfectly comfortable but of course, don't support a urethrecole. Unfortunately, I have such torrential periods I couldn't cope with a sponge at that time.

However, I'm feeling really deflated about the sponges. They hold it up - they're very soft - I donn't feel them. Do you really feel that they could have a negative impact on healing/ make things worse? Having used them for three weeks I went without yesterday and, who am I kidding - I felt awful and bulgy - probabaly worse than I had last month. I tried the workout without one and felt worse, bulge seemed to be lower down afterwards and truly droopy after the firebreathing, which I'm almost afraid to try again because this happens each time I try it. I'm just concerned that the prolapse will get rapidly worse without their support. I know you mention elsewhere on the site that they're great for anterior wall defects, and that you do endorse them. Is this for short term use, while healling? Do you think it's a good idea to wear one while exercising?

Apologies for the barrage of questions.

Doubtful

Christine

September 28, 2010 - 9:04am

Doubtful - I think the sponge is an ideal pessary if your tissues can tolerate the surfaces of it. It squishes down between the walls and allows for closure. If I could wear a sponge, I most certainly would! :)

kiki

September 28, 2010 - 2:34pm

HI Doubtful,
I am sorry you ar efeeling worse. Ups and downs are normal--hang in there.

Are you worried about tampons during your period? I don't think using them for a few days is going to make things worse. Sponges definitely don't work for mine either as it is heavy as well. But i do know that when i wear one, i need to watch what i do as i can't feel my body telling me that something is too much. so do just listen very carefully and stay within your limits. When i workout i don't like to have one, as i like to feel what feels good and what doesn't. Firebreathing and nauli definitely help lift if i do it right. i know at first i wasn't, and it didn't feel good. Once i figured it out, it helped.

How do you feel your posture is? When i went ot NM to see Christine I realised how much more pulled up i needed to be than i realised! I really feel like i am sticking my chest out (but everyone says i don't look like it--i just look like i am standing up straight for once!). Search on my post about visiting the WW Centre--if you click on my name you can track me and find it. it may help, as Christine gave me some clear pointers to help tell when i am doing it right.

And it takes time...it won't go away over night, and you have to believe that it can get better or i think fear takes over. When i first got my pop i dedicated a year to healing. everything was about healing--and it gave me a space not to even consider surgery in that time (luckily the doctors wouldn't either...). at the end of the year i was so much better--and continue to improve. Going to NM was a revelation and from that things have improved even more--even with my digestion going completely out of wack this last week which would usually really upset my POP.

so really look at what you are doing, and hang in there. it's early days.

doubtful

September 29, 2010 - 3:31am

Thanks so much Kiki and Christine for your very prompt and helpful responses. It's reassuring to decide I can use a sponge
without worry, but of course, it doesn't replace everything else, and mindfulness.

I'm starting an anti-inflammatory diet becuase so many women on the forum report an improvement with it. As I also have severe hayfever, ocassional patches of inflammed hand/feet joints, ectopic heart beats
( following a viral heart infection - benign, but they flare up at times) and occasional adult acne, if the diet doesn't help my prolapse there's a good chance it could help some of those so what's to lose?

Incidentally, I'm just starting the exercises in the book rather than the DVD workout. I find all the upright beding and stretching really helpful. I'd been struggling with the posture - getting very stiff around the ribs and back expecially for the seated postures, but these exercise really seem to help the whole torso and back pull up more naturally - I feel lighter, which can't be bad for the posture/ pelvis. I'm still completely baffled by the firebreathing and nauli - seems to be a common theme with a lot of women on the site. I get the instructions for the firebreathing, it's just that the second stage sends my prolapse dopwn not up. Perhaps it's more for women with cervical prolapse rather than urethrecole. The nauli - well - I've searched youtube and really haven't a clue.

Anyway - one stage at a time. Thank you for your help, and I'll let you know how I get on in a few months. Maybe one day I'll feel better enough to offer words of advice and encouragement to other newly prolpased women.

Doubtful.