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.

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