New Here - Uterine Prolapse

Hi Larkspur and welcome to the forum. Don’t despair. At 14 months PP your body is still recovering, particularly if you are still nursing. If you have a mild uterine prolapse, the posture corrections can help. Sitting is pretty much the same as standing. Endeavor to keep the lumbar curve in place; don’t lean back and collapse your spine, but rather, sit forward and use the strength of your spine. The relaxed belly and pulled-up chest will keep that curvature in place. Firebreathing will help, have you tried? Kegels don’t do much of anything for uterine support, but if you do them, make sure you’re in good posture, and don’t overdo it. Sex can actually be good for moving the organs up, so don’t avoid it out of fear. Most importantly, there are many young moms on here who have had more babies after discovering prolapse, and are now the same or better. Work on posture and firebreathing and just let nature take its course! - Surviving

Hi Larkspur

You lucky duck, having an OB like that! Sounds like a wonderful birth. Why can't other OB's have this sort of patience, and let women birth when their bodies are ready??? It sounds like she is really thorough and has your welfare at heart. She is honest, and she is right. There is not a lot that doctors can do.

I think you will find that Whole Woman posture will improve your prolapse considerably. Combine it with a healthy diet, clothes that don't compress your belly, and using your body in ways that are supportive of pelvic organ support. You could put a wedge on your office chair to make it more horizontal, and just don't lean against the back. I am sure you will find ways of adapting your environment, rather than letting it dictate how you use your body. Just be patient. You have been like this for a while. It may take a while to improve, or it might improve quickly.

I would suggest that you stop diarying daily, and just measure every couple of weeks. Measuring is interesting, but it can become a bit of an unproductive obsession. One thing you will have discovered is that your cervix does move around quite a bit. That's what it is meant to do, so the configuration of your pelvic organs can change to accommodate a uterus full of arms and legs, a full bowel or a full bladder, or all three sometimes!

Re sex, yes, your fears of intercourse are unfounded. There is nothing quite like an erect penis for putting organs back where they belong. Don't forget other ways of being intimate too. It is not all about penis in vagina. You can use positions for coitus where your lumbar curve is intact to move your bladder and uterus out of the way. Think you on top, leaning forward, and in control of your own enjoyment and comfort. Or if you are on your back, lie on a pillow from the hips up, so your lumbar curve is intact. Either of these ways will make your pelvic floor tighter, because a good lumbar curve makes the opening of your pelvic floor bigger, and that makes the muscles across it stretch more. The geometry of this is in Christine Kent's book, Saving the Whole Woman.

Take it gently. Wine helps. Just make sure that your husband knows that you are not rejecting him; that you just need to get brave enough. Men can get really insecure at times like this.

Oh yeah! Remember to use lots of lube, mother's little helper. If you are still breastfeeding a lot, you still might not have very high oestrogen levels.

Louise

Here's hoping you go OK.

Dear Larkspur

You say you are a bit worried by constipation. I’m not sure whether you are having loose, difficult to pass stools, or hard, difficult to pass stools.

If the former is the case, look for foods that may be causing this. I found two such foods; any chocolate and a low fat ice-cream that used fructose and artificial sweetening. You may very well not eat either of these things, or do, and yet find they do not affect you in the same way. What I’m suggesting is that you look at the foods you eat, starting with any processed snacks and you may find some correlation between them and loose stools. Maybe keep a brief food diary for a few weeks. Remember that loose stools mean they have accelerated through your bowel, so it is a mater of avoiding or reducing the amount of those foods that do this. Magnesium is known to help, as do probiotics, but as you are breast feeding baby, these may not be an option.

If, on the other hand, you have hard stools, you can afford to eat foods that will accelerate elimination. But again as you are still breastfeeding you are probably limited in what you can eat in regards to elimination acceleration foods like prunes, stewed fruits etc or even the last resort, laxative.

Why not try lubricating the entrance to your anus with a lubricant, just do it in the morning after your shower. This simple act can relax things down there and also grease the wheel as they say and will help hard stool to pass more easily. Something like petroleum jelly was once a favoured lubricant, and is still widely used, but nowadays is frowned upon in certain quarters (I think for the possibility of breathing it into your lungs), but some olive oil or coconut oil can prove just as effective. When stool becomes really impossible to pass, you might use a suppository or an enema. If you have never used these before, the thought of it can be off putting, but once you have done it once (like a lot of other things done in moments of great desperation), it becomes easier. Also consider these last as an emergency and temporary measure until you get your diet sorted.

Try not to strain as this does not help the prolapse. With uterine prolapse it is difficult to avoid straining, but do try to resist the impatience as much as you can. Elimination is easier sometimes if you lift off the toilet seat into a half squat and this is what is recommended here. Squatting is recommended to be done with knees parallel. Your weight moves forward more onto your feet and your thighs are brushing the toilet seat. Sometimes I do this, and at other times I sit upright on the seat in full WW posture. It depends on the nature of the stool. Yes, I know absolutely TMI.

I had back ache to start with when I began adopting the WW posture. Normal there, unless you are worried about something else, you haven’t mentioned.

Baby is heavier now and much more active, make sure you take some time out to rest.

Cheers Fab

Back ache while getting used to WW posture can also be because you are actively using your lower back muscles to lift your tailbone. Try putting your right thumb on your spine between your bra strap and your waist and the left thumb on the bottom of your coccyx. Push the right thumb forward a centimeter or so. your chest will automatically rise, your lumbar spine will move forwards, your pelvis will tilt slightly forwards, and your left thumb will feel your coccyx rise automatically, hopefully without back strain.

It can take a few weeks to become less uncomfortable, but lower back pain is common until you get your mechanics sorted out. Feeling your own body, and how different movements cause different changes in your posture, can be quite illuminating.

Louise

Hi Larkspur

This is the dilemma of rectocele. We think that in normal posture, or when the butt is tucked and the tummy pulled in, it tilts the pelvis back, and straightens the lumbar curve. This means that the trunk loses most of the bend at the top of the sacrum and all the weight of the abdominal contents is concentrated on the pelvic floor. This means that the sigmoid colon sinks deeper into the pelvic cavity and squashes down on to the rectum, which kind of gets bent. When you feel the urge to defaecate the kinks in the rectum prevent the rectum from emptying, just like the kinks in a garden hose. No matter how soft the stool, much of the stool cannot get past the kinks and get out. The aim of firebreathing and nauli is to pull the sigmoid colon back out of the pelvic cavity and move it forward, and to allow the rectum to stretch out again. Once you have done this for a while, and maintain a posture that keeps the pelvic outlet pointing backwards instead of straight down, the top of the vagina will move back against the rectum, and the bladder and uterus will be folded forwards and pin the front vaginal wall back against the back vaginal wall, which in turn pins the rectum back so it cannot sag and get kinked as it fills again. Somet5hing like that anyway. It could also be your uterus pressing on the rectum, if your uterus is retroverted, ie bent backwards instead of forwards. This would have the same effect. A retroverted uterus doesn't shift easily, particularly after many years, but my retroverted uterus did flip forwards a few years into WW posture. It made my periods much more comfortable. You can tell where and how your uterus sits by feeling it with your finger. If it comes out of the front vaginal wall your uterus will be in normal presentation, anteverted. If it pokes straight down from the roof of the vagina it is standing straight upwards. If it is coming out of the back vaginal wall, then it is most likely retroverted, and kept in that position by your intestines. In an extreme situation it might becoming out of the back wall and pointing upwards. This indicates that it has tipped right back and is upside down, with the top of the vagina tipped correspondingly forwards, with the uterus stuck down between the back vaginal wall and the rectum. I think this is where mine got to.

The only way to get the uterus forwards seems to be to wind all the organs up and forwards, so the vagina can move backwards. You might be able to understand this better by having a look at a series of quick and dirty images I posted on the Whole Woman Village's Facebook page, http://www.facebook.com/photo.php?fbid=3669023163691&set=o.372777748545&... . There is a loose membrane, which I have nicknamed Kent's membrane. It spans the pelvic inlet, and is the barrier between the abdominal and pelvic cavities, but it is quite floppy, so it can accommodate distention in the pelvic organs, eg stool in the sigmoid colon, urine in the bladder and a foetus in the uterus. It also has a kind of funnel arrangement near the sacrum where the colon enters the pelvic cavity, so the colon can move in and out of the pelvic cavity, without compromising the barrier. You can see by my imagined rendition of this membrane that it has a lot of ability to change shape, according to where the organs are at the time. You can see how the pelvic floor on the lefthand image is truly at the bottom of a relatively straight, vertical trunk, whereas the centre image has the pelvic cavity almost horizontal, and gravity acting downwards, through the pubic section of the pelvic bones, which literally underpin the bladder and the uterus.

I don't think the zero gravity recliner will do you too much hard when reclined, but I would be putting a rolled towel behind my waist and hips if I was sitting in it in the upright position, so that my pelvic organs were kept forwards. When you are lying down gravity will act straight down through your back, not down your vagina, so it should be fine. Go ahead and enjoy it.

The obtuse angle caution is about straightening the lumbar curved, so removing the angle in the trunk which protects the pelvic floor from intraabdominal forces, which cannot act around corners. The obtuse angle would apply if you were sitting in the zero gravity chair without a lumbar support, or sitting on the floor, doing situps or yoga's boat pose, http://www.myhappyplaceyoga.com/roanoke-yoga-full-boat-post/ , where it is extremely difficult to maintain the lumbar curve. Imagine what pressure there is in this young woman's pelvic area! This is a yoga pose that we *do not* attempt particularly with straight legs! with bent legs it is possible to reinstate the lumbar curve, but it is still not easy to do without vulval pressure when you have prolapse.

Louise

Along with everything Louise mentioned - add to that the thinning of the vaginal wall .. so that whenever the rectum is full there is little resistance from the vaginal wall, like a balloon which has lost its elasticity ... the contents of the rectum balloon into the vagina/perineum ....
Therefore when you do have to go - trying to keep everything on target is a tricky business.
Splinting provides the resistance the vaginal wall once did - and also supporting the perineum to ensure everything exits via a direct route rather than being sidetracked and 'stuck'.

I have a recliner chair which I love as it aids the stress on the lumbar discs and disperses the weight ratio .. but sitting upright I am always with a lumbar curve.

Try walking as much as possible - it always helps to get things moving.

Dear Larkspur

I find sitting on the toilet bowl in WW posture with my neck raised, my head back, forehead almost parallel to the ceiling, like the posture of a toddler when walking, though you are seated and with your lumbar curve in place helps Takecare’s concept of “direct route exit” when you are having difficulty passing soft stools.

Note that aspartame used to sweeten Metamucil is banned in children’s products in Europe. Suggest you seek an alternative. Not meant to panic you. The little you had is not going to do much harm, but you’d do best to avoid frequent use from now on just to be on the safe side.

Straight psyllium, the effective ingredient of Metamucil, works.

Cheers Fab

What kind of cyst, what kind of surgery? Hope it all goes well for you! Keep us posted. - Surviving

Good luck larkspur on your surgery, please keep us posted here! - Surviving

Dear Larkspur

Thank you for that re Metamucil. The granular varieties contain sucrose, the sugar free and smooth varieties contain the aspartame. The capsules I don’t know, they don’t seem to say unless there is something under the label where they say to pull back for allergy information.

Good luck with the op.

Cheers Fab

Just make sure that the ovarian cyst is all they touch, Larkspur. And find out what they plan on doing if they decide that it is malignant before they test it, and decide to remove your ovary just in case. I don't know what is normal in these situations, but *you need to know in your situation*, so they know exactly what they have your express permission to remove, and what they don't have permission to remove. Ask them about different scenarios.

It might be interesting to also know what caused it in the first place. They may or may not know. Does anyone else know anything about the causes of ovarian cysts?

Best wish for the op, Larkspur.

Louise

Anyone who has read Nora Coffey's book knows some sobering truths about the powers of a surgeon, to use his own discretion to do whatever he feels is best once the patient is opened up, regardless of what the patient did or didn't give permission for on the consent form. Good luck and let us know how it goes. - Surviving

That's good to hear, Larkspur. I do hope your improvement continues. When you research thoroughly and communicate clearly with a doctor you can get a good result.

Now, your next challenge is to get less hectic!

Louise