What's the best option for an 84 year old?

Submitted by littlesheep on June 9, 2012 - 12:19pm
Body: 

Hello

I wonder if anyone can offer any thoughts or advice for my mum She is 84, was hysterectomised in her 40's and now on the verge of having an operation for cystocele and rectocele respectively. Alerted to the dangers of mesh, which she has been told will be the procedure used she will be inquiring about other alternative methods.

She tells me she can't empty her bladder fully without squeezing it out . I'm not sure about the rectocele. I think she would cope with it if it wasn't for the back ache and the feeling of dragging down and discomfort when she walks and stands even just for a little while. There is also soreness. There has been a little incontinence, not much, she only uses the light pads, but I suspect this has been worsening over time. Her posture is very poor. with a forward stoop, no s bend visible at all. I can understand her thinking an operation might be a good thing, even though she really doesn't want to go through with another op.

Her other health problems; wet macular degeneration which has resulted in a degree of sight loss, rheumatoid arthritis and osteoarthritis (unable to kneel or bear extra weight on her knees) as well as very bad posture would make it difficult or nigh impossible for her to undergo any form of exercise or postural readjustment program at this stage in her life that isn't really gentle, let alone read a book adequately! She could watch a DVD. Not having seen the w.w elders video. I wonder whether it would be appropriate for her especially as I would need to purchase a DVD player in order for her to view it.

I wonder if anyone can offer any comments on this situation. Maybe there are some old fashioned ways or devices that might help relieve her discomfort. A pessary was tried and promptly removed due to pain it caused. She has agreed to ask about and try other types, I understand there are a variety of choices, perhaps someone could advise on this. She tells me a tampon would just come straight out. I have a vague notion there was something used in the old days like a sling or harness, hard to imagine I know but if anyone knows, anything to prevent my mother undergoing an op at her age please let me know. The surgeon has advised her to go through with it! Is it possible that an op at her age and condition is the best solution. If so, what type of op should it be?

Thank you to anyone taking the time to read and consider this posting.. I am grateful to all you out there who are making a contribution to us all maintaining our womanly wholeness. I look forward to and would greatly appreciate any replies.

I

Forum:

WholeWomanPA

June 9, 2012 - 4:57pm

Dear littlesheep,
Today I was helping a friend deal with her 96 year old mom. I am glad you are there for your mom. In the May 2012 issue of Consumer Reports they discuss the problems with the mesh. There is a first hand report. The woman now is in terrible and incurable pain and now has additional problems. They also have a quote from a reputable doctor who says the surgeries do not work and do not improve the problems just make more. Christine Kent was way ahead on this. Glad your mom (with your help ) is asking questions. I would probably seek a second opinion from a non-surgeon. Also, even though she has no way to view a DVD if you or someone is nearby you can learn the posture and teach it to her. I would start with the posture ,standing and sitting. I'd explore diet and natural stool softeners for the rectocele. Teach her that her bottom should not press into the toilet seat. Show her how to rest her forearms near her knees. (semi-squatt) Most important no straining or pressing down on the toilet seat.
There are other pessaries. Christine supports only the thin ring,inserted vertically. Trouble is the hysterectomy may impede the value of the pessary. It is very hard to fit these women. There are some support garments that might help. (most are not appropriate). Christine suggested one for another aged friend of mine. When she reads this hopefully she will remember the name of the garment. Mostly, we need to help your mom feel comfortable and feel more at ease with her symptoms. After that you can think about the elder's DVD which in time might be good for her. Right now I think posture, perhaps a pessary and support garment are the place to start.
Good luck and let's continue talking,
Whole Woman PA

alemama

June 9, 2012 - 7:20pm

trouble emptying bladder
dragging feeling with walking and standing
backache

The bladder you can help with immediately. Show her how to pee- have her try standing in the shower. I know she can't go down on all 4s- but maybe she would be able to lean forward and bend her knees a bit.

the dragging feeling and backache may be helped by massage and acupuncture. Otherwise WWPA has given great advice as far as a support garment goes- that might really help.

And don't give up on the pessary yet, give that another try.

jaylove

June 9, 2012 - 7:54pm

Hi, I just wanted to suggest that if you have not already - you might want to go the top of this page and click on FAQ's and then click on Theatre then click on Wholewomen 101 and watch and listen to Christine Kent. Valuable information. Also, You can type in any word or words to a question you have and past-post will appear with information regarding the subject. Best of Luck to you and to your mom. Whole Women PA was right - your mom is lucky that you are there for her. Bless you!!

Jaylove

littlesheep

June 11, 2012 - 5:14am

All of this is fantastic valuable advice for me which I need to research urgently before my mother reports back to her GP on Wednesday for her second opinion. I shall go and do that and then get back with more questions no doubt.
Thank you Whole Woman PA, that answers just about everything and I'm particularly interested in the support garment. i shall find the copy of Consumer Report, try to print and show it to her. About stool softening, I know she takes fibrogel. Does anyone know if this will suffice for the time being? It can be difficult to persuade some elderly people to change their old ways and beliefs, but I will try.
Thankyou jaylove for suggesting where to look, will save so much time.
Thank you alemama, the shower idea sounds great, but unfortunately there isn't one, only a bath. As she can manage to get in the bath she might like to try this at least now and again to help keep the bladder flushed. She has reticently been considering acupuncture recently for another problem, so I think your comment will prompt her to do it and maybe massage too. Very timely.
My intention is to print out all your replies and show them to her (she can read some things and with the use of a magnifier makes it easier ) then she can read over it at leisure and it doesn't feel like it's just me telling her what to do. I might be able to copy Christine Kent's comments to audio CD for her to listen to. All more meaningful coming straight from the source rather than me. Thank you, thank you, thankyou. Back soon x

wholewomanUK

June 11, 2012 - 8:58am

Hi littlesheep,
I'm so glad you've found this site and finding some support for yourself and your mum. Having experienced a painful and uncomforable prolapse myself last year I empathise with you mother and her predicament. I vividly remember thinking "I cannot go on like this". Then I found Whole Woman thankfully - and now live a happy healthy life - and manage my prolapse daily.
I agree with all that's been said above. Having read some of the details of what surgeries actually involve and the short and long term problems that can arise post surgery, I think you're right to be very wary of surgery. It really should be a last resort not a first.
One reason not to opt for surgery at this point is that once you've had surgery that's it, ther is not turning back and what's done is done. However, if you try the Whole Woman way - in the worst case scenario the prolapse has not improved you still have the surgical option. (Your mum could even give herself a deadline such as 6 months?) The Whole Woman option works with women's bodies in a safe holistic way. There is information and guidance about physical health and pelvic organ support, posture, exercise, psychological support... all of which can bring about improvement in prolapse symptoms. Basically there are things that can make pelvic organ symptoms worse and things you can do to make them better.
I do think the dvd for elders might really suit your mum. It's very gentle. I gave a copy to my mum, who sounds like your mum. I don't know where you're based, but also there is a small but growing band of WW teachers. If it's possible to see someone that would probably be really helpful.
The WW way is safe, natural, far cheaper than surgery and works. Having said that, it does take some personal interest and commitment and it does take time. It took years for the prolapse to develop, so it's understandable it takes time to improve. I do sincerely hope your mum gives the Whole Woman way a go, but ultimately it is her choice and her right to choose.
Wishing you and your mum all the very best. We're thinking of you both.
xwholewomanuk

littlesheep

June 11, 2012 - 10:01am

Hi, and thank you so much for your reassuring comments. I am from UK and delighted to hear from someone else from UK. I shall try and find how to send you a personal message, I think there's a way, but I am just inter-netted out at present. Been on it all day. May be tomorrow. I look forward to replying to you then. X

wholewomanUK

June 21, 2012 - 8:33am

Hi littlesheep,
My apologies for not picking this up earlier. I'm also in the Uk - delighted to make your aquaintance! I'm 1 of the recently qualified WW teachers. I've picked up your email and will respond asap.
Best wishes, wholewomanuk

Magic 12

June 29, 2012 - 7:46pm

On this same subject, I had a hysterectomy 6 months ago at the age of 74. Today I need a cystocele repair again and now a rectocele has been added to the list for the surgeon. Because of the immediate failure of the cystocele repair, I wonder if the tissue is too fragile to maintain proper alignment. Actually, the WW posture is very comfortable and I am trying the exercises. When could I notice improvement? Most of your advice I have already discovered on my own due to the prolapse of the uterus last year. I wish I knew of your site before the hysterectomy. What comes next for us older gals?

Surviving60

June 30, 2012 - 2:28pm

Hi Magic - If you are doing the posture and it feels good, I'd say just keep it up! Your hips will thank you more and more as time goes by. It sounds like you are already making your next surgical plans. Based on what you've already had done, we can't say whether you'll be helped or harmed by further surgeries. They do tend to fail over time, and repeat surgeries usually fail in an even worse way. Putting that on hold and working instead on posture and exercise will do no harm, and might help you to have a better relationship with your body. Prolapse is forever, and the work we do to stabilize prolapse without surgery is forever too. - Surviving

louiseds

July 1, 2012 - 12:44am

Hi Magic

If there is any hint of prolapse a doctor will pick it up one way or another, and probably offer surgical repairs for it, because that's what gynaecology surgeons do, and that is all they can do. Generally, they are not interested in finding out ways of putting themselves out of business by conserving a woman's body, instead of removing and rearranging it. If you went to see him again tomorrow he might give you a slightly different diagnosis. Of course, they ask you to bear down during an examination. That will make anything bulge towards the entrance to the vagina, that can bulge!

Surviving is right. The more surgery you have, the more you will need, and the first surgery is the most likely to succeed. After that the procedures become less and less successful, because they are tightening up and stitching up more and more of a system that is designed to be mobile. Our bodies are designed so that all organs can move independently, but are also tethered to each other, to allow for a full bowel or rectum, a pregnant uterus or a full bladder, or all three!

Last well woman check I had I didn't bear down very hard at all, because I could see little point in it. The doctor who was examining me had difficulty finding my cervix and said I didn't have a rectocele and only a slight cystocele.

It is not the diagnosis that you should be concerned about. Having symptoms and dealing with them is your priority.

What symptoms you experiencing now? And how much does it bother you? Is your cystocele worsening now, or is it stabilising?

Louise

nevaeh

July 3, 2013 - 7:30am

Magic, we are about same age. I just turned 75, had my hysterectomy years ago and now suffer from rectocele, cystocele, and vaginal prolapse. I have tried kegals, PT, pessaries, etc etc and am now told by my uro dr the only options I have are surgery or to live with it. Please, keep me informed of your progress and maybe we can be of help for each other. I have learned so much from these forums and everyone has been so responsive and helpful.

Surviving60

July 3, 2013 - 11:26am

Nevaeh, just wanted to point out that Magic hasn't been back on here, and it's been over a year. So there's a pretty good chance she won't see your post. But I hope she does, it would be nice to have an update. - Surviving