E-string bother rectocele

Submitted by Katharine on November 6, 2006 - 9:16pm
Body: 

I've been using e-string as I'm menopausal, hysterctomized, and allergic to glycols (all 7 or 8 of them...propylene glycol, butyl glycol etc.) and all parabens in Premarin vaginal cream and any other vaginal creams on the North American market (pharmaceutical grade ones that is!). Compounded estrogens have sketchy levels of estrogen in them and seem to cause bladder infections, likely due to improper sterilization of olive oils or purifed waters used in them.

Anyway, does anyone have problems with the sensation of e-string putting pressure on rectum? Am I crazy or is this just me? Is this perhaps because e-string slides down vagina? In some ways e-string acts like a pessary and helps vaginal support, but in other ways it seems to make rectal problem worse? Does anyone have an explanation for this or a similar problem?

I've read in a few posts that e-string may make rectocele worse? Does Christine perhaps know if this is true or not, and can she explain why this is so?

As I can't use vaginal estrogen creams I'm not sure where to go with all this.
Katharine

Christine

November 7, 2006 - 9:56am

Hi Katharine,

I've read your messages with such empathy and so wish I had more ideas for you.

It's not surprising the Est-ring is bothering your rectocele. Your tissues have probably thinned considerably and picture pressing across the middle of a water balloon - a bulge is created or worsened. This is also the simple dynamics of a pessary that doesn't lay flat between the vaginal walls.

With all my might...

wishing you well,

Christine

Katharine

November 7, 2006 - 8:20pm

Christine,
Your comment makes a great deal of sense. In a way, the e-string does feel like a bar of sorts pressing across the middle of a water balloon.

I'm wondering, since the e-string is not a pessary really, whether there is a type of pessary that does not bother rectoceles? I'm aware there are shapes of pessaries other than the classical donut. I've seen cube shaped ones online etc. Would another shape of pessary other than donut assist with rectocele comfort? If so, if you have the name of the shape, I will ask my urgynaecologist to prescribe it.

Secondly, I'm wondering if you have ever encountered a physician who does vaginal collegen injections for those of us with very thin vaginal tissues? I often feel that if I had more fat in the vagina and vulvar vestibular area, I would have more support, and less rectocele droppage. Alternatively, does ultrasound or any other such non-invasive procedure thicken vaginal wall? I've heard that sex can do this, but at the moment, and since hysterectomy sex is far to painful to even contemplate even with my most considerate husband.

I must say, I'm really quite miserable, and only 41 years old. Rectocele and pelvic floor droppage is making me feel very old before my time. I often wonder if my tissues and vagina/rectum feel this badly now, and if my tissues are this thin at 41 yrs old, what horrible condition will they be in when I'm 80. I believe my tissues are so thin due to taking Lupron Depot for rectal/bowel/bladder/cul-de-sac, ovarian endometriosis. Lupron was a horrendous drug that makes one menopausal immediately upon injection as it stops the pituitary gland from working entirely. To this day I feel that Lupron Depot has had long lasting effects with respect to bone pain, tissue thinning, estrogen reserve depletion etc., but I cannot do anything about its long-term effects at this point as in Canada no class action lawsuit is taking place. Nevertheless, this drug should be removed from the market....sorry for my rant. Living the next 30 years (providing I live this long) is too long in this chronic state of rectocele and vaginal misery. I know there must be others out there like me.

I think it would be interesting for you to survey how many of your pelvic floor cases have had hysterectomy, how many have had endometriosis (and what stage endometriosis and where), how many had vaginal hysterectomy (which I did and I believe this caused the rectocele), and how many have taken Lupron Depot for endometriosis cure (which is does not cure), how many had forceps delivey, episiotomies and the list goes on. An online survey with questions of this sort when signing up for memberhip to your page would make this rather a simple task and I think the statistics could be telling. The medical community could use this data I'm sure.

I really appreciate your help with all of this and hope you can answer at least a few of my questions. You are clearly very dedicated to helping others and I suspect this is a very draining task at times. It is often hard to hear about and assist others with miseries the same as one's own.

All of your advice and any help you can give me will be gladly taken.

Thank you for your kindness.
Katharine

Christine

November 8, 2006 - 11:36am

Dear Katharine,

What you are experiencing is the reason Whole Woman™ exists.

The cause of the motility problem is that your bowel, which used to be barricaded into place by the broad ligaments of your uterus, has dropped outside the “physiologic pelvis” where it can no longer be overcome by the forces of intraabdominal pressure. You can push and push and get nowhere because your rectum is no longer subject to natural pressure increases. However, it does sense the prolapsing and continuous pulling and stretching of its nerve fibers, which you experience as pain and pressure. Katharine, even if collagen injections or ultrasound treatments were part of the experimental panoply, no amount of bulking up of the vagina is going to lift the large bowel back into its functional position. It's unlikely any of the pessaries will work after such bowel prolapsing, although we have had the occassional post-hysterectomy woman write in that she is using a pessary successfully.

The next step in the standard operative protocol would be to implant surgical mesh from the perineal area behind your back vaginal wall to your sacrum in hopes of lifting your perineum and bowel back up. The delicate nerve plexes that control bowel movement must be handled during this surgery and permanent bowel paralysis is one of the most serious risk factors. Another is mesh erosion. A third is developing all manner of autoimmune problems for having overwhelmed the body with so much “debris.” And a fourth is that the surgery may not make a difference in your symptoms, but simply move the bulging and pressure elsewhere. An honest and expert surgeon would review with you all long-term risks.

You’ve traded one condition for a set of others and now only you can decide if you wish to continue with the standard surgical management of prolapse. If not, accepting your disability and lovingly supporting your body as it is while growing your Spirit is another option. This might include:

• Spending much of your time seated with strong upper body posture (seated in the ww posture will take pressure off your tailbone and rectum.)

• Practicing the standing posture for short periods of time while wearing an external support garment (see www.prenatalcradle.com for the V2 Supporter.) Most of our intestines are carried toward the front, which would suggest that the posture would only naturalize your pelvic interior as much as possible.

• Working with your environment to healthfully support you.

• Working with your relationships to healthfully support you.

• Daily mild enemas or the most natural dietary supplement for bm.

• No sex – it is a reality that most castrated women experience sex as emotionally and physically painful.

• Joining or beginning a group of supportive women.

• Joining or continuing with a spiritual community.

• Working toward change.

With Hope & Grace,

Christine

Katharine

November 8, 2006 - 7:17pm

Thank you Christine for your well-explained physiological reasons for my pelvic floor feelings. It does make sense. I recognize that surgery may not help and that this sort of problem is endemic on my mother's side. My grandmother who died at 93 had uterus and one ovary removed at 36 due to fibroids. Thereafter, she, like me, suffered extreme bowel problems. During her last 30 hears of life she was in and out the emergency room at our local hospital, unable to evacuate her bowels. Fleet enemas daily did little to ease her discomfort. She did not sleep at night due to bowel pain. My mother likewise has rectocele and cystocele due to four vaginal births, but hers do not seem to be as bad as mine.

I'm only 41, and nearly in the condition my grandmother was in at 93 years. Looking forward to a lifetime of this is not possible. People need hope to continue on in life. I really am going to have to look at alternatives. I'm giving myself two more years of good solid posture work and pelvic floor work. If I fail, and do not improve I'm afraid colostomy may be in order. Life is not tolerable the way I am now. However, it does seem pathetic and sad to remove a good bowel just because of pelvic floor. Medicine has really not progessed in the past 200 years. Our practices are archaic.

I understand your spiritual component. However, although I'm a believer, my Presbyterian roots say that God only helps those who help themselves. I'm not one to sit back and stew and God has yet to help me during the 8 times I've been on the operating table to keep removing my endometriosis, trying against all odds not to have a hysterectomy, which in the end I had. I've had 25 years of mind-wrenching, gut-wrenching, hot-poker-like endometriosis pain and resultant horrendous bladder problems. I learned far too late that the number one symptom of ovarian endometriosis is bladder problems...feeling of bladder infections, interstitial cystitis symptoms. Bladder problems caused by my ovarian endometriosis were my lifetime horror. Once my ovaries were removed my bladder is actually much improved...the constant inflammation in my bladder and on it is gone. I left the disease far too long unbeknownst to me. It grew into the rectum, basically destroying it. I had deep rectal endometriosis that was excised during an 8 hour operation...who knew the stuff could grow into your rectum. I certainly was never told this was the result of leaving endometriosis too long. Who knew endometriosis could attach one's cervix to the rectum. Mine apparently did this. No wonder my rectum is messed up. My endometriosis was so extensive the surgery was worse than most extreme cancer excision surgeries. Unfortunately, despite complaining to my doctors about my gut pain for 20 some odd years, I was simply told I was a neurotic woman. Classic!

I'm not angry with you by the way, just venting. It feels good to get the anger out. The bottom line is, no pun intended, is that I'm not so sure I'm prepared to suffer another 20 years with problems as I've already endured too much. However, listening to others on this site, I will give myself two years, see what can be done with respect to proper diet and exercise (although my diet has always been superb but could maybe use some tweaking...I'm thinking of trying a rotation diet to see exactly what irritates rectum). I'm not overweight so losing more weight will not help.

What I can say, and this is where I'm discouraged is that thus far, despite 2 years post-hysterectomy and proper exercise, pelvic floor therapy, Mitzvah classes (specifically designed pelvic floor exercise for proplapsed women...I do these daily..no increase in pelvic pressure in these exercises...taught by an osteopath trained in Mitzvah), posture exercises etc., my problems are worsening. At this point, colostomy seems a welcome alternative, but I will wait 2 more years.

I will need emotional help over the next while to get through this hump before things improve. Ventilation on this website helps. I've simply been sitting the last couple of days and really basically stuck on the toilet between 8-12 noon and wanting to go repeated throughout the day and at night. I want to defecate all night long some nights and simply lie thre trying to control the urge. Rectocele is very bad the past week and I cannot do much. I don't enjoy sitting it annoys me. I'm more of a doer. I feel like a tiger in a cage. I'm a type A personality by nature and am having trouble becoming a Type B. I'm uncomfortable pretty much all day and miserable as a result. Good thing my husband goes to work early so he doesn't have to endure my trips back and forth to the loo all morning.

Anyway, I've winged enough. Thank you and keep me posted and any ideas you may have to help improve the quality of my life will be welcomed. I apologize for not finding much solace in spirtual things. At this point, they just annoy me as I'm very, very, very angry. I've forgiven my doctors but I cannot forget.
Katharine

Christine

November 8, 2006 - 10:39pm

Hi Katharine,

I applaud your courage and strength. Keep all options open, for even a suspension surgery may be a reasonable path for you.

Drawing the comparison to your grandmother as having also suffered a negative surgical outcome, caused me to ponder how different the two conditions – endometriosis and fibroids – are.

In other systems of medicine these are defined by all the other aspects of constitution and personality that make up a whole person. In Ayurveda for instance, endometriosis is found to occur mostly in women with characteristics such as lightness, quickness, dryness, subtlety, thinness, roughness, and coldness; while fibroids plague women with traits like heavy, moist, slow, calm, and deliberate.

Severe imbalances are seen within the context of the whole person and from this perspective the very worst treatment for endometriosis would be surgical invasion of the body – the very thing that would cause or exacerbate such symptoms. Long-term treatment would probably include rest, regularity, a warm and moist diet, and frequent warm oil therapy.

Thank you so very much for joining us and for making such a powerful contribution to our awakening.

Christine

bigmomma

November 9, 2006 - 7:58am

Katherine,

My heart really goes out to you and I hope you will find some comfort somehow, whether surgically or otherwise. It is not fair that you have had to endure so much at such a young age. Although I also have rectal issues, they do not seem to be nearly as uncomfortable as what you are experiencing. I truly hope that the future holds some solution to your suffering and that God will give you some peace. Please keep us posted to any changes that diet and or posture may give you as I feel we have much to learn from you here.

HUGS,

Bigmomma

granolamom

November 9, 2006 - 10:24am

I have been reading all of your posts, I haven't yet replied because I honestly don't know what to say. You have endured so much, you are in so much pain, nothing I say can change any of that. I think you must be very strong to come here, post so honestly and be willing to open you mind to yet another way to manage prolapse.
I guess I just want to let you know I am listening. I hope and pray you find some relief of your symptoms and some hope

blessings

heartfelt57

November 10, 2006 - 12:13am

Hi Christine, I've been reading Katherine's post and my heart goes out to her..I have similar problems, not quite as bad and I just don't think all the support in the world is going to take that pain away or help your marriage and your other relationships..Most family members just can't get a concept about all the pain we go through. They get tired of hearing about it year after year. My one question to you right now if you don't mind explaining is something you stated in your reply to Katherine. No sex - it is a reality that most "castrated" women, etc. What do you mean by castrated? I need to know..Thank you so much, heartfelt

Come near to God and He will come near to you. James 4:8

God Bless All Women

heartfelt57

November 10, 2006 - 12:38am

Katherine I'm fairly new on this sight but what I've read of your post so far I just want to say I am praying for you...I know how discouraged you can become toward God and anything spiritual when you hurt for so long..I am contemplating cyctocele and rectocele surgery pretty quick here. I have been miserable for several years now and in the hospital with bladder and kidney infection 4 times this past year. I'm getting immune to the antibiotics which scares me. I need to lost weight and exercise but with the cele's and five bulging disc in my lower back I can hardly walk..I've pretty much made up my mind to have the surgery and pray that it helps. My marriage is gradually getting worse(not much sex as you well know) and I'm 56..I can't see living like this for many more years. I may lose my husband and everything I have..My children and grandchildren also want a Mother and Grandmother that feels good once in a while. What about a Colorectal Surgeon? I mean find the very best you can and talk to them. Surely someone out there can correct your rectal problem...By the way, my doctor told me that having a complete hysterectomy at 37 has dried up my body and could be causing the tissues(between vagina, bladder and rectum) to be so dry..Also I did have a complete vaginal hyst.(I noticed you mentioning these things to Christine) I also had a bladder lift and rectocele repair at that time 1988..It all came back a couple of years ago..with age I'm sure...I know things have improved greatly since your poor Grandmother suffered so bad. I'm praying you find the perfect doctor for you that really has your best interest at heart.
I can do ALL things through Christ who strengthens me. Phil 4:13
God Bless You and May He give you physical and spiritual comfort.

Come near to God and He will come near to you. James 4:8
God Bless All Women

Christine

November 10, 2006 - 11:47am

Dear Heartfelt,

“Castration” is the medical term for having lost either testes or ovaries. As you know, it would be the very last and most dire treatment for a man. Yet, by age 65 approximately one-third-to-half of all women in the US have lost their uterus/ovaries to common hysterectomy.

The blood supply to the ovaries, uterus and vagina comes directly off the great iliac arteries branching from the aorta of the heart. Although the ovaries and uterus have their own branches from these larger vessels, these merge and surgeons describe a “continuous arterial arcade” connecting this blood supply all along the sides of the ovaries, tubes, uterus and vagina. Illustrations of the “arcade” resemble a highway of arteries and veins running up and down the full length of these structures.

Removing the uterus is cutting away the heart of this arterial and venous blood flow and no way can ovaries and vagina remain healthy thereafter. Not only is their major blood supply disrupted, but also their nerve conduction and lymphatic drainage. I’ve wondered if the large post-hysterectomy belly is a result of impaired lymphatics, but can’t find any studies on the subject.

I know it is very, very hard, Heartfelt, but the clear light of the truth is the only thing that can make us whole again.

All Love,

Christine

louiseds

November 13, 2006 - 9:36pm

Hi Heartfelt57

I just picked up on your comments about bulging discs. I have these as well and have had physiotherapy and exercise programme which concentrated on strengthening my transverse abdominal muscle and other muscles that support the offending spaces so that I could brace my spine more effectively so the discs don't get squashed so easily and could heal themselves. The exercises helped a bit, but not to the extent of fixing the constant pain and muscle spasm.

That was all before I learned Wholewoman posture, and how the sacrum and pelvis interract with the spine.

I previously lifted heavy objects with a straight back and bent knees, treating the spine as a column which was as straight as possible. My standing posture held my butt tucked in which kept my lumbar curve flattened. I now realise the importance of the lumbar curve, and that the spine is not a column at all, contrary to what all therapists and doctors have ever told me.

If you look at the lumbar vertebrae you will see that they cannot straighten out without putting pressure on the front of the discs that separate them because the upper and lower surfaces are not parallel. Hence, correct posture was injuring my discs. I am paying now for my lifetime good-posture diligence.

Now I carry myself with a pronounced lumbar curve and a very straight middle and upper back. It has taken about 12 months for my body to adjust, and I see further improvement all the time.

Now I see the spine as more of a construction crane with broad support at the base (sacrum, pelvis and associated stabilising muscles), a tension member on the topside and strong compression-resistant bones (ribs & pelvis) and muscles on the bottom side. This crane can wave around in the air at any angle and do the lifting it needs to do with its arms. It is stable leaning straight forward or nearly upright. So now I lift with my crane leaning forward, back musles in tension, muscles in and around the pelvis and abdomen in compression (kneeling rather than squatting to get down low if necessary)and my butt sticking out, so as to maintain the lumbar angle and prevent squashing of those discs, and keeping my pelvic organs over my pubic bone instead of hanging over my pelvic floor, bracing with all my abdominal muscles and trying to relax my transverse abdominal muscle so my belly can absorb the intraabdominal pressure when I lift. It sounds complicated, but is simpler to do!! At last I am getting somewhere with my bulging discs, and can do all sorts of things at ground level again without days of pain afterwards. I am also sleeping with a small pillow in the small of my back, or waist height if I sleep on my side which seems to be maintaining my lumbar curve while I sleep. I am now a lot less stiff and sore in the mornings, and loosen up more quickly.

I have come to the conclusion that standing in my 'old good' posture was just balancing the vertebrae on top of each other and not utilising the muscles around the pelvis and spine to do the stabilising, so all those muscles weakened and were unable to do the stabilising work required when I was lifting. Now they get their strengthening exercise just by sitting, standing and walking. They are working all the time and much better for it.

Just remember that Wholewoman posture is at the heart of it. Just keep those pelvic organs forward of the pelvic floor opening, and well over the pubic bone and they cannot descend because there is a big lump of bone in the way!!

I hope this will help you to understand this one aspect of your body. If it wasn't for Christine's model of the importance of the lumbar curve I would never have worked this out. Goodness me, isn't the human body just the most amazing piece of machinery! One bit is changed and the rest has a really hard time adjusting. I wish you well as you make difficult decisions about your own body. It's greata that you can still support others at the same time.

Cheers

Louise

Christine

November 14, 2006 - 9:25am

Louise,

What an awesome description of your return to natural biomechanics! I know I've suggested this before, but there is a fascinating dvd by Stephen Levin, MD on biotensegrity. He's an orthopedic surgeon turned biophysicist - a very brilliant guy who didn't like the way things were going in his field and set out to discover the true function of the human spine. You can find it at www.biotensegrity.com

Christine

louiseds

November 16, 2006 - 6:49am

Hi Christine and All

Levin was a great help in understanding all this Christine. I can only endorse your suggestion that is worthwhile checking out his work, if just to see the same conclusions coming via a different, but related model.

The crane analogy came to me while I was watching a TV news item about food aid being delivered in Africa. Tiny women each collecting a full size (180lb?) bag of grain on their shoulders/heads?, off the back of a truck and bouncing off into the distance with their spines at quite an angle, flexing rhythmically as they walked, and bottoms sticking out. No way their spines were acting as a column!! It is all just a big springy skyhook with a wide and stable base. I have never again thought of my own spine in the same way again.

It was just after that when you first mentioned Levin and the tensegrity structures. It all made such perfect sense. I am now always on the lookout for images of women (and men) from primitive tribes who are very physically active, to see what sort of shape they are, and how they carry themselves and loads. They're not so easy to find these days, especially unclothed so you can really see how their bodies move. Prudishness has taken over.

Cheers

Louise