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Lactulose & pelvic floor following 3rd degree tear.

(24 Posts)
shouldIbecrossaboutthis Tue 09-Oct-12 06:52:39

My baby has finally arrived and everything went really well apart from getting a tear sad I've got some antibiotics, painkillers, anti inflamatories & lactulose which I've been taking as instructed.

Just have some questions someone might know the answer too as I'm not sure when I will see MW today.

Basically (TMI warning!) my poo is really really runny and im gong 3/4 times a day sad also my tummy is making very odd noises and is kind of sore and a little windy / crampy. Is it due to the lactulose do u think? I take 15ml morning and 15ml night. Would it be ok to cut down on it? I feel daft asking but dont want to take my morning dose today really but won't be able to check with MW first.

The other thing is when shall I start pelvic floor? After stitches dissolve or right away? I'm being referred for Physio but not sure how long it will take & not sure if I should wait for Physio before trying?

Thanks for any advice; I'd be lost without mumsnet at the mo, I'm asking silly questions all over the place grin

Longdistance Tue 09-Oct-12 06:58:49

I'd be tempted to stop the lactulose. When I had dd1, I had the worst constipation, as in couldn't go, and was prescribed Movicol.
If your stools are normally hard, it may be worth staying on it, so it's easier on you with the tear, or perhaps contact our gp or mw, and maybe take just one dose.

mayhew Tue 09-Oct-12 12:48:56

Sounds like too much lactulose. The aim of it is just so you can go without straining. Go to every other day doses. If not enough, once a day.

If you can control your bowel and bladder, then your pelvic floor is on the mend. Normal moving around starts to tone it. When you feel ready, maybe 2 weeks, start gently tightening and releasing when you are feeding your baby. That will remind you to do it. As you feel it respond your confidence will increase. Once you feel it moves when you want it too, try doing 5 strong squeezes followed by 5 slow lifts and lowering. That encourages all the muscles to activate. If you do it most times you feed the baby you will feel progress. The other exercise that helps is pulling your belly button in firmly and holding it there while you do not hold your breath. At first it will seem impossible but gets easier day by day. This pulls up your pelvic floor from the inside and also reminds your waist to come back.

cravingcake Tue 09-Oct-12 19:00:40

Start your pelvic floor excercises now. I had a 4th degree tear and started doing them about a day after the birth. You wont really be able to feel what is going on, with the swelling and bruising and pain killers but just try to do the 'action' that you hopefully practiced while pregnant. Trust me, it helps.

Trust your instincts on the lactulose, as an above poster says it is to help you go without straining so if its loose then you dont need it.

Also, right now there are no silly questions to ask the midwife, dont be worried, they've heard it all before.

One last tip - try using a hair dryer (low heat) to dry your bits after a bath, much more soothing than rubbing/patting with a towel.

And Congratulations on your new baby.

shouldIbecrossaboutthis Wed 10-Oct-12 06:29:55

Thanks everyone! I skipped the lactulose & only had the PM dose, feel so much better!

Tried doing pelvic floor could not feel a thing, worried now going to be wearing tena lady for the rest of my life smile it'll get better right? Sometimes some wee comes out before I make it to the loo, is this ok? I think I'm leaving it too long between weed as I did pre r
Labour? Going to set a phone reminder today!

Thanks again everyone, I had the baby early Friday morning & still haven't seen a midwife. Is this normal?

Enelya Wed 10-Oct-12 07:41:23

You should have seen a midwife on day one at home, sounds like you have been missed off the list. Give the midwife team a call, or the hospital where you gave birth!

shouldIbecrossaboutthis Wed 10-Oct-12 11:33:44

I called them yesterday and they said someone would come and see me, waited in all day but nothing. Called again today and someone is coming by 3pm hopefully. My usual midwife is on hols so I'm guessins I've fallen through the cracks sad.

gussiegrips Wed 10-Oct-12 11:52:49

I'm a women's health physio. You are my favourite kind of poster...

Get going with your pelvic floor exercises - working the muscles will help reduce the inflammation round your stitches and make you feel a Whole Lot More Comfortable.

Watch your poo-ing. You don't want to be going 4 times a day, but don't let yourself get constipated. Really, don't.

Don't worry too much about being a wee bit leaky, you are only a few days post delivery and your nethers are still going to be in a bit of shock! It'll take a good six weeks for your uterus to shrink back down - and for your undercarriage to heal up.

Doing your exercises will only help. I'm on a personal mission to rid the world of leaky ladies - a third of us have ishoos. It's a political disgrace that you can have a baby and not have anyone educating you properly about your pelvic floor.

Imagine you are bursting for a pee - hold for a count of 10 secs. WHen you let go there should be a "drop", if you don't feel that then you've lost hte contraction and you need to increase it one second at a time until you reach 10. 10 is the magic number because there's a reflex that will reduce the urge you feel if you can hold on for 10 seconds. Without that, you'll wet yourself on the doorstep when you try to unlock the door.

Then do 10 quick flicks. That's the work your pelvic floor needs to do when you cough/sneeze/laugh

Then imagine you've got a wee lift in your speshul place. Lift it to the first floor, second and third floor - and then back down. This is hard, you'll probably not manage it for the first few weeks, but it's the one that stops you from wetting yourself when you walk downhill in high heels.

So, lots of quick flicks and long holds to help reduce your inflammation just now. ANd, by 6 weeks, you should be doing the weird lift one too.

Make sure you see a midwife, ask her to talk you through them, mention you are having some leakage issues.

I'm looking at trying to persuade MN to run continence as a campaign. A third of women 35 -55 wet themselves. Half of women 55+ wet themselves. They don't know what they should be doing, and there's real suffering out there as a result.

I'm tweeting x3 day to remind you todoyerblardyexercises - stick an "@" in front of my name and follow me on twitter. Use it as a prompt to do the exercises. It's really the only way.

Congrats on the baby, and you've earned a shiny for thinking of your pelvic floor at this sleep-deprived stage!

Cheeseandonioncrisps Wed 10-Oct-12 16:39:07

Hi, I suffered a 3rd degree tear 8 weeks ago and also had lactulose morning and evening but was given fybogel to take twice a day also which bulked up the poop so it wasn't so runny but soft enough so I didn't have to strain. The doc will prescribe it but you can buy it over the counter as well. X

shouldIbecrossaboutthis Wed 10-Oct-12 18:04:07

gussiegrips, you crack me up; I think you helped me on another thread too! I don't have twitter but evreytime I fed the baby I did my pelvic floor, flicks and holds grin.

What exercises do you have to do for your bum?!

gussiegrips Wed 10-Oct-12 22:26:55

bum cracking you up? Oh, stop it now, folk'll wet themselves with your punnage!

The bumhole muscles and the peehole muscles are essentially the same thing.

Now, anatomists will get all cross with that statement; but from a functional point of view - the two pelvic floor muscles (one of which has three different bits with three different names) and the gristle that holds it altogether has the same nerve supply, so it's really a moot point when it comes to doingyerblardyexercises.

If you do the lift exercise (best not to think about the bad imagery much. Especially do not think of Arriety Pod et al) then you'll engage all the pelvic muscles, both concentrically (the way they are supposed to work) and eccentrically (against gravity, the way they have to work downhill, in heels)

If you aren't sure what you are doing try this visualisation:

1. bursting for a pee. Have been since checkout at the supermarket. You've unloaded the car, you've got the shopping at the door and you now Really Really Need To Go...but you can't find your keys. That's you contracting your front bit of the pelvic floor.

2. First date. With a bloke you actually like. You're nervous, been out for a curry the night before and are due your period. You need to have a proper, good fart, but under no circumstances is that going to happen because It's A First Date, and you'd like there to be a second. That's you contracting the back bit of your pelvic floor.

The two bits work together. They share nerves, if you think of squeezing at the front you'll also be squeezing at the back...so, we may as well multi-task.

You could argue the point that you need to do separate exercises. But, I'd argue the point that it's hard enough to remember to do 10, 10, 3 - so let's keep it realistic and functional.

On the other hand....have a look at this woman good grief that's above and beyond the call

PiggyMad Wed 10-Oct-12 22:43:20

I had a 3rd degree tear 6 months ago and did my exercises religiously and had no symptoms at all. After starting some vigorous exercise sessions recently, and doing a couple of jump-squats too many, I realised that I have let my pelvic foor exercises slide blush
Thanks for the useful tips gussie!

shouldi I couldnt feel anything at all when I first started doing the exercises after birth, but the feelings gradually came back as the swelling went down. Congratulations on your new baby!

gussiegrips Thu 11-Oct-12 12:41:58

Jump squats. <shiver>

gussiegrips Sat 13-Oct-12 10:39:12

How are you doing, cross?

FirstTimeForEverything Sat 13-Oct-12 14:48:26

Message withdrawn at poster's request.

gussiegrips Sat 13-Oct-12 17:26:47

First that's awful. I hope they gave you a cup of tea nad a biscuit after all that!

Do persevere, and if you are not sure, or not happy with your progress then flag it up to your midwife. And, make sure they check you at your outpatient appointment.

If you need motivation, google uterine proplapse. Actually, don't. Just doyerblardyexercises three times a day, minimum.

Congrats on the baby and on taking time to look after yourself.

FirstTimeForEverything Sat 13-Oct-12 19:58:11

Message withdrawn at poster's request.

seabuckthorn Sat 13-Oct-12 20:24:19

Hope you are doing ok OP and feeling better.
Sorry for this tiny hijack...
Oh gussie if you are still there: please help me, I cannot seem to do pelvic floors, I don't know what I'm doing what I'm holding up or lifting. I don't feel a drop after 10 <sob>

gussiegrips Sat 13-Oct-12 21:49:51

Don't panic, Mr Manwairing!

It IS a bit odd, trying to work your pf. Once you get the hang of it it's a breeze. Did you ever do those weird books of patterns that you looked at, and squinted at, and crossed your eyes at...and then a 3D image came jumping out the page at you? Well, pf is like that - once you've got it, you'll know what to do and wonder what was so tricky about it in the first place.

The thing that makes it hard is getting biofeedback. If you want to strenghten your biceps, you bend your elbow - you can SEE the muscle working at the same time as you can FEEL the muscle working. So, knowing how to strenghten your bicep is easy, tha'ts biofeedback.

PF floor is trickier. You can't see it, you can't see what the contraction looks like and, often times, women are so unaware of their bodies that they've never really thought about even having muscles Down There.

Assuming there's no reason why you can't get them to work (like MS, or previous birth trauma, or previous surgeries)...try using a bit of gravity to help

Lie on your back, bung a pillow under your hips so you are lying uphill.

Bend your hips and knees.

Take a deep breath in, really fill your lungs and sigh it away.

Do that three or four times, until you can feel the rise and fall of your tummy as your breathe (Try not to fall asleep here)

Now, imagine you are bursting for a pee and there's nowhere to go. Really visualise it - so, imagine you are at the end of a looooong check out queue. (keep breathing) Your trolley is packed with essentials - milk, bread, nappies, calpol, and wine. You cannot abandon your trolley - you need the calpol for your baby who's seeing the doctor tomorrow for ear-ache. You know you've got a sleepless night ahead of you, you need this stuff to manage (specially the wine) Keep breathing.

There's three people in front of you. You don't have enough time to get to the loo and back before it's your turn. You don't want to ask the business suited man in front of you if you can skip in front of him. It won't take that long, will it?

Now, stop paying attention to your breathing and focus on your bits - feel what they are doing. That squeezing feeling at the front of your vulva, where the pee comes out, that's you working your pelvic floor. Really squeeze - (ohmaigawd, I'm acutally going to WET MYSELF!) really, really hard. You are looking for a "lift" Your pelvic floor's job is to hold your organs up, it's action is to lift - it's a very slight lift. Imagine trying to make enough space for someone to slip a £50 note into your gusset.

Now. Stop. And breathe. Feel the difference in the front of your vulva where the pee comes out? It should change from feeling tighter to, well, probably nothing, but you might notice that you'd not get a £50 note in there.

Try again. "ohmaigawdI'mgoingtopeealloverthefloorinfrontofallthesepeople"

relax

and again.

relax

and again.

Still nothing? Knickers off, put your fingers over the front of your vulva where the pee comes out (you know, the bit wee girls hold on to when they are holding on. And, the bit you'd loooove to give a bit of a rub when you're bursting to go - only, people would think you were a bit peculiar) and imagine you are bursting for the loo again - push down on that bit with your fingers as you squeeze to stop the imaginary pee - can you feel a lift?

(keep breathing)

stop and relax

try again

relax

try again

relax.

STill nothing?

Well, if it's within your comfort zone to have a rummage about - put a finger or two into your vagina (doesn't actually HAVE to be your fingers. Any willing volunteer will do. Or, a vibrator, or a broom handle - ehm, maybe not a broom handle, splinters, ouch)

Do that lot again. Really imagine you are in the shop. You are aware of the clock on the wall, the lenght of time that stupid woman is taking to chat. IS SHE GETTING OUT MONEY OFF VOUCHERS? This is taking forever! Why can she not remember her pin number, stupid cow. Imagine yourself trying to subtlely shift your weight from one foot to the other, trying to jiggle up and down on your tiptoes without looking like you are bursting for the loo. Think of the sounds of the chattering (stop talking, get on with it!) the beeping of the till, the announcements in the background, the slight sweat you are getting on and the fact you've already mentally sacrificed the pound you put in the trolley because you just need to get the shopping in the car and get home!

Now, can you feel a squeeze? Round your fingers? Not in your tummy, not in your buttocks, not in your thighs - but round your fingers? That's it. That's your pelvic floor. ARe you blue? If you are working your pelvic floor you should still be breathing, if you are holding your breath and going a bit squiffy you've not got it.

Not sure? Leave your fingers (or, the end of the golf club, whatever floats your boat, really) where they are. Stop trying to squeeze, relax and breathe. Three or four deep breaths - now, compare the feeling round your fingers with that of during the squeeze. Does it feel different?

Not sure? Try again.

relax

Again

relax

Still not sure? Well, don't panic, Mr Manwairing! It'll take a bit of practice and a bit of patience. Keep doingyerblardyexercises - and don't well, try not to worry.

Give it a week. Doyerblardyexercises every day, at least 3x a day. Do that great big palaver at least once a day - more if you can make time for it.

Don't spend more than 20 mins doing the lying with your ass up on pillows thing. You'll just get fed up and despondent. 20 mins of good quality training twice a day is better than an hour once and then never bothering again becaue what'st he point?

Give it a week. If you STILL can't feel anything at all, then it's worth arranging to have a chat with a physio/nurse/GP about getting a biofeedback gadget. That's got a bit shaped like a tampon that attaches to a machine which will give you a number measurement of the strenght of your contraction. So, you learn to associate the feelign with the number going up, and if you are competitive, you'll want to beat yesterday's number.

It takes a bit of time and a LOT of effort. I can help via twitter (@gussiegrips - when I tweet, you twitch your twinkle x3ish a day), or here. Or PM me, or, if you prefer, email me - details via twitter on on my profile here (am trying to be careful not to advertise! Please note, there's no charges for my witterings on here. And, I am a little bit obsessive about trying to help leaky ladies)

Remember to relax inbetween. Really, really important to relax. And breathe. Generally speaking, breathing is A Good Thing.

Oh, and might be worth printing all this off so you don't have to disengage the baseball bat to hop off the bed so you can read what the next bit of what you are supposed to be doing from the computer screen.

Relax. The people who have the problems are the people who don't KNOW they have a problem, so you are already streaks ahead because you are smart enough to want to do something about it.

Now, go and get your kecks off. x

seabuckthorn Sat 13-Oct-12 22:00:09

Yes Miss! I am saving this page and will be doing this first thing tomorrow. Thank you very much for replying!

seabuckthorn Sat 13-Oct-12 22:09:35

Yes Miss! I am saving this page and will be doing this first thing tomorrow. Thank you very much for replying!

gussiegrips Sat 13-Oct-12 22:16:20

should have said - you can buy biofeedback machines, cost about £100 - £150 . But, I wouldn't advise you to get one unless you'd had a proper assessment. If you've got a prolapse which is getting in the way, or if you've had some nerve damage you didn't know about then you'll need treatment with someone who knows what they are talking about, and you can save your money to spend on wine.

LEt me know how you get on.

shouldIbecrossaboutthis Sun 14-Oct-12 19:14:20

I think I'm doing ok, tear Ross healing nicely but I have a cyst that's giving me some issues!!

But I've been doingmyblardy exercises! I can feel stuff now smile

shouldIbecrossaboutthis Sun 14-Oct-12 19:15:06

*tear is healing nicely. Blardyiphoneautocorrect

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