Living with prolapse

I’m feeling the need to whinge to the world in general. A living with prolapse post is one that for ages I’ve been wanting to do, but also not wanting to do, because it is so so personal. Yet, the very worst thing about this particular injury is how hush hush it is. I was stoked to see a proper mention in Clementine Ford’s mothers’ day post, because the silence and the hidden nature of the problems are a big factor in feeling shit about things. I feel worst about it when another mum says something that indicates she has a functional pelvic floor and this wave of resentment and isolation washes over me. I don’t wanna be the bitter killjoy who’s sneering at a happy tale of jumping on the trampoline, but fucksacke, I want to be able to say I can’t do something and tell the real reason without looking like I’ve scandalised everyone. It’s just a broken vagina, what’s so scary about that? Bodies can get injured and this is an injury caused to my body when a baby came out of it.

I have a rectocele prolapse, which means the back wall of the vagina is damaged and the bowel protrudes into the vaginal canal, in my case eclipsing the opening of the vagina. When the little dude was a baby, the rectocele was significantly worse and the bowel would often protrode out of the vagina, causing a painful and uncomfortable bulge about the size of a golf ball. This was hell. By the end of the day, I would be unable to stand because the protrusion would get worse and worse, very painful and uncomfortable. I would have to lie down with my legs up to try and recuperate. I spent a lot of time playing games with baby D where he’d lie on my raised legs and I’d pretend he was a plane, it was about the only thing I could do over and over that didn’t hurt.

I also have a cystocele, which means the front wall of the vagina is damaged as well and the bladder protrudes into the vaginal canal, eclipsing the opening at the other side. This means that the bladder and bowel effectively collapse into each other within the opening of the vagina, which causes discomfort whenever I walk or stand. I also need to be careful how I sit. However, compared to the situation when the little dude was a baby and the bowel bulged out, it’s fairly manageable.

I had a three hour second stage of labour with D, and this caused immediate damage. There was nothing I could have done differently to prevent it except go back in time and have a totally different birth. No-one told me that I shouldn’t lift heavy things after the birth, or do activities that create impact on the pelvic floor, and I didn’t know so in the first few months after D was born I did things that certainly would have made it worse. When I talked to my GP about the symptoms, she referred me a to physiotherapist, and I went fortnightly for several months. Since the physio, I’ve been able to manage it to try and repair some of the damage and avoid further strain – including though the second pregnancy.

Things are much worse at the end of the day though, a whole day of gravity and fatigue makes it hard to do the physio-recommended trick of slightly engaging the supporting muscles to help minimise the collapsing sensation.

It won’t necessarily be like this forever. There is the option for a pessary to be inserted into the vagina to hold things into place, however there is also a chance that things might improve spontaneously after B is weaned (hormones have a big role). I haven’t looked into a pessary yet because they are best used once symptoms stabalise, and throughout B’s first year there was ongoing gradual improvement. But I should probably make an appointment about a pessary soon because it’s probably not going to get much better until weaning. There are also surgical options to consider once B is weaned. These carry risks, including the potential for future surgeries, and given I’m fairly young it might be best to put off surgery if I can manage with the pessary. Almost definitely on the cards for the longer term future though.

There are lots of activities that exacerbate the symptoms, causing the bladder and bowel to protrude lower. This feels like a dragging weight in my vagina; or, when it is caused by something sudden, it feels like a downwards punch through the pelvis. I experience significant discomfort when I do things that increase the gravitational pressure on the pelvic organs, for example:

  • Coughing
  • Sneezing
  • Lifting heavy things
  • Carrying heavy things (like the kids)
  • Standing for upwards of fifteen minutes, and even less at the end of the day (walking isn’t so bad as long as I’m not carrying anything)
  • Defecating – and I had a tummy bug recently and it’s why the symptoms are worse lately.
  • A lot of yoga poses,  but yoga is also good for strengthening, so I should keep doing it but be very careful to modify the routine and be aware of my own limits.
  • Stumbling or tripping over
  • Shouting
  • Standing on a bumpy bus
  • Going up in a lift
  • Bouncing the baby on the edge of the bed to get him to sleep

There are also things I can’t do at all because they might cause further damage, like jumping and running, or carrying heavy things for more than a few minutes. I kept babywearing D after I should have stopped because I didn’t realise. But with B, I stopped when he got to be about 7kg.

Living with prolapse means living with a constant, nagging discomfort, except when I’m lying down or sitting just right. Whenever I’m walking, I have to very carefully try and engage the muscles a bit and walk as smoothly as I can. I can’t carry the kids very far. Often, I’ll sit down because it feels uncomfortable, and then I’ll forget why I sat down and get up to play with them, then be reminded – oh, yeah, damn. Sometimes I do things like spin D in the air because it’s nice to feel like an active spry parent, but I almost always regret it quickly. I recently signed up for a work volunteer day on Matiu Island but now I’m worried, that was stupid, that might involve lots of activities that exacerbate symptoms (bending and pulling weeds, stomping down on a spade, carrying heavy things). I feel like crying because I forgot, I forgot that I can’t do all the things I used to enjoy.

I feel flustered and anxious when I hear of professional sportspeople getting pregnant. At least my job isn’t made any harder. 

I know there are much worse injuries, much more serious limits on what our bodies can do, but I still grieve the body I had before kids. The body that ran a half marathon. And it’s so hidden. There is no way anyone I meet would know unless I told them. Perhaps someone else with exactly the same problem might notice based on small behavioural things like spending an oddly long time in the bathroom, or not jumping on the bouncy castle, but probably not. To anyone who sees me I look like a fit and able-bodied young mum.

One big factor in how prolapse makes life harder is the chores. Isn’t that stupid? At the end of the day, I’m too sore to run around and quickly get chores done. My life would be so much easier if I could do more things in the evenings, but it is quite painful by then. A big issue for me managing the symptoms while living my normal life is the fear of being seen as slacking off or piking, which I should probably let go of. For example when we went camping while I was pregnant with B, I did none of the dishes because by that stage of pregnancy the extra baby weight meant that standing up to do the dishes was extremely painful. But I felt anxious the whole time that I wasn’t doing my fair share. My husband forgets sometimes, and I feel so pathetic reminding him that I need to sit down, I need to walk more slowly, I can’t carry these things, I’m a bit injured and broken. And it’s all the time.

Sighhhhhh. Please, no-one tell me that having kids young means you bounce back more quickly after the birth. Especially the use of the word “bounce”. It’s just too cruel.

A small vignette in advance​ of mothers’ day

On Tuesday, the mother is sick. She leaves work early, gets the bus home, and goes straight to bed. She is woken by the noise of the children coming home with their father and grandmother. They keep the kids at bay as long as they can, but the baby is fractious and wants a breastfeed and he’s wailing out for it. His grandmother brings him in. He sees his mother and wriggles and squeals, so delighted, so excited that she’s there for him. He tries to launch himself at her, crawling over the bed, tugging at her shirt. The grandmother smiles sympathetically at her daughter and sits down next to her on the bed, as the baby feeds. The mother lies there half asleep and anxious about being sick when there is always so much to do, and the grandmother places a cool and calming hand on her brow. Stroking the head of the young woman as she cradles her youngest baby. The mother notices herself relax, feeling with each caress that some of the stress is being taken away, and being carried back up through the generations. 

The over-achiever trap

I spent yesterday evening reading this amazing piece by Maddy King, recounting her recovery from a traumatic head injury and her new insights from the experience.

The detail about living with concussion was absolutely fascinating. But I also found a lot of it relatable as the tale of an over-achiever forced to re-evaluate, similar to Holly Walker’s pieces on growing up and anxiety. There’s a mindset that was common among our cohort, can-do-anything/must-do-everything, and it seems a lot of us are shedding it as life happens. Good.

Going through school and uni the 1990s and 2000s we were told told to aim high. Setting goals was all the rage, self-evaluation was an integral part of the education system, and the idea of pushing yourself was very prevalent in the broader culture. No-one talked about being perfect, because of course no-one is perfect, but they talked about continuous self-improvement. A never-ending attempt to get better and better and better and do more and more and more and more. For girls, it was all heightened an extra level. You have all these opportunities previous generations never had! Make the most of them!

The culture we grew up in was competitive and individualistic. This was a brave new world where university fees mean you can’t muck around finding yourself, nope, you need to focus, what are YOU going to do with YOUR LIFE? You only live once! Make it count! Oh, but also ENJOY IT! Find your passion! Quickly.

We emerged to adulthood, shiny and bright like fresh minted coins, expecting that we’d change the world with our awesomeness. All the possibilities were open for us!

Maddy writes:

Overachievers like myself are often scared of contentment, because being discontented, dissatisfied with our own progress, unhappy with the state of the world – that’s the fuel that drives us to push ourselves further and do bigger and better things. Some even go so far as to call constant dissatisfaction an entrepreneurial mentality. But I believe this pattern leads to bitterness and stress, unhappiness and misery – and the self indulgence this creates means we’re in no fit state to come up with ground breaking ideas, we can get absorbed in the tunnel vision of everything that’s wrong with life. It’s not the answer. Cultivating deliberate contentment gives us a peaceful and positive outlook, and leaves us with the fertile mental space to see new connections and solve crucial problems.

We believed the bullshit about high expectations being the path to success, and became accustomed to exceeding expectations. (The phrase used for the top available mark on my intermediate school reports!). Trying to aim high all the time is a fool’s errand, it keeps upping the ante – if you exceed the expectations all the time, you set new expectations; if you fall short of your high expectations but still do well, you feel inadequate anyway. Maybe you hand in something that’s only OK, and someone tells you with a frown “this isn’t your best work”.

My grandmother used to say before exams “you can only do your best, remember!”, and I would feel like screaming: THE WHOLE PROBLEM IS STRESSING ABOUT WHETHER I WILL PERFORM AT MY BEST ON THE DAY!

For many of us, worrying about the things we should be doing has become a constant background hum. To the point where it’s obviously ridiculous if we stopped to consider it rationally, but we’re so used to it that we barely pause to think how draining it is to live with, and how completely unnecessary.

Some examples: I feed my kids scrambled eggs for dinner a couple of times a week, but I feel bad their dinners aren’t more interesting and varied. I buy my lunch most office days, but feel bad for frittering money away and not making my lunch. I feel bad for feeling bad about these things, because part of me wants to be a version of myself that doesn’t give a fuck about things that don’t matter. There’s maybe three or four layers of stress-hum for each of those things.

Honestly, the things I can feel weirdly inadequate about are almost never-ending. I compare myself professionally to people my age who don’t have kids, which is absurd; or to people who have kids the same age as my kids but who are ten years older than me, which is even more absurd! I compare myself as a parent to only the nicest memories from my childhood, or to parents of older kids who seem to have things more sorted, or – classic pitfall – I think of the best days of my parenting life as the standard and feel disappointed when they’re not all like that. I cherry-pick too, taking the most successful bits from other people’s lives and feeling like that part of my own life falls short – rather than considering it in the whole. (Oh, I’ll have the PhD thanks but I’ll pass on the huge student loan. Cheers. Also I’ll take the overseas travel, but without the complete running down of savings. And could I please have the stay at home husband but not take on the sole breadwinner role for myself?)

Here are some things for which I am currently vaguely disappointed in myself:

  • Eating eggs. I feel sad about the baby boy chickens being killed. But I like eggs and I’m still breastfeeding B and eggs are very nutrient-dense and a good food. But baby chickens dying. And the misleading free-range labelling scandal. I don’t wanna eat sad chicken eggs, bad enough that I’m complicit in animal exploitation at all!
  • Not doing more to learn te reo and teach D, who is interested in languages, and like a little sponge at the moment for learning new things.
  • Ditto for Hebrew.
  • Not doing more to teach D about Jewish stuff.
  • Not sending D to the Jewish kindergarten, even though it doesn’t fit with my working hours and doesn’t take babies so we’d have to send the kids to separate creches.
  • Not being remotely interested in unschooling the kids at all.
  • Not sending the kids to a kohanga reo.
  • Giving too little money to causes we believe in.
  • Spending too much money on eating out.
  • Not doing enough to keep in touch with my friends overseas.
  • Not doing enough to meet in person with my friends in Wellington.
  • Falling behind on D’s dental hygiene.
  • Not hanging out enough with my husband without the kids.
  • Not being directly involved in politics or social justice activities at the moment despite having no time.
  • Not having a clean house.
  • Checking my phone too often.
  • Getting grumpy too often.
  • Not having done post-graduate study.
  • Not being empathetic and patient enough with D.
  • Not knowing when to be firm with D or how to be firm with D without being stern.
  • Not having time for this blog despite lots of things I want to write.
  • Not being comfortable enough with the gaps and the cracks. Not relaxing enough and just going with the flow.

That’s not a complete list by any means. It’s just a few things off the top of my head to give a smattering of how random and inconsistent the collection is.

How can we avoid feeling like this, when we’re bombarded constantly with messages telling us to do things differently and better? Lots of those messages are well-meaning, and useful, but all the different SHOULDS start to get into your head. Should should should should should.

D’s three year old dental trip was the other week, and the dentist put on a serious face and told me about prevalent weak spots and needing to brush better, every night, every morning, high-strength fluoride toothpaste, big risk of cavities, etc etc. Okkkkkkkk yes dental hygiene is important. I had a root canal when I was five. He’s inherited my crap teeth. It’s been a major preoccupation since the visit, trying to find a fluoride toothpaste he likes, buying a new toothbrush he’ll hopefully prefer, telling him no more marshmallows with his fluffies. And the brushing is… not going well. We’ll get there. I ordered some strawberry toothpaste from the USA, it hasn’t arrived yet. We’re trying to explain the importance of teeth brushing without making him overly anxious about dentists and fillings. ARGHGHGHGHGHGH. I know this is important, but also, I have this tightening in my stomach of remembering that sinking feeling as a child who was so so so good about refusing lollies, who brushed so carefully, and yet who was still told by the dentist every single time “you need new fillings”. And they never just told me like it was a thing we had to put up with because that’s life. They always had to make a big fucking deal about how I needed to brush even better and never have sugar.

When I was 16, miserably awaiting the news about how crap my teeth were at my latest check-up, the dentist said “maybe you should completely stop eating fruit if that’s the main sugar in your diet”. Sometimes the final straw can be good because it makes you realise how heavy the load has become. OH FUCK OFF. FUCK OFF WITH YOUR STUPID SUGGESTIONS. MAYBE BODIES ARE FRAGILE AND THERE IS A LIMIT TO HOW MUCH WE CAN REASONABLY DO TO PREVENT BAD THINGS HAPPENING? HUH? EVER CONSIDER THAT, MR DENTIST?

There’s a whole obsession with living your best life, finding the best way to do something. Even if it’s finding the midpoint between two different extremes, it feels like it’s not enough to be somewhere in the generally medium zone, you have to be at the exact right point.

And it’s all such bullshit!

Life’s too short to worry about whether you’re living your best life.

But by now those habits are very entrenched. The background anxiety is entrenched. The tendency to calibrate ones satisfaction against every other option you could possibly do – and in so doing, find the satisfaction slipping. I saw someone last week who I hadn’t seen in a long time, and she asked if we were still thinking of spending any time overseas. Honestly, I don’t know. Do I have to think about it? I could easily be alive for another fifty or even sixty years! Going overseas to live and work with the kids is not currently on the agenda. Can we talk about the here and now? I know it’s chit-chat, but when did chit-chat become so focused on future plans rather than current life experiences?

B just learnt to walk. He’s understanding new words every day. He loves throwing balls and bopping to music. His favourite foods are orange and avocado. My job is going really well, it’s really interesting. We just had a lovely visit from my husband’s sister, who saved our skins stepping in to look after D while he was sick and unable to go to creche. When he was better and bouncing off the walls, we went to Kilbirnie Rec Centre and he rode his bike around and around the courts. He wanted to push me on one of the sturdy little go cart things and I said ok and it was hilarious, he ran so fast and it must have looked bizarre but I laughed and laughed and laughed. My husband and I had an argument over who took the sick leave for D on Monday and I felt very frustrated with him but then the next day he bought me flowers. Today I needed to buy a present for the third birthday of one of D’s friend’s and I decided before I set out that buying presents is going to be on my “don’t worry too much” list. When they didn’t have the type of Duplo set I wanted, I bought the next thing I saw that I liked and didn’t even look around to see if there were better options. Go me! And tonight I downloaded the Wiggles teeth cleaning app and we’ll try that tomorrow morning.