Anyone had a 4th degree tear....and a colostomy :-(

[spudballoo]

Hello everyone,

I gave birth to my beautiful boy 2 weeks ago, alas not the homebirth I'd planned but a very long, 3 day, difficult labour. All very traumatic, and ended with a forceps delivery. Whilst the delivery was in fact easy (he was low down in the birth canal, but being held back by a very short umbilical cord) the forceps caused me major internal damage. I went straight to theatre to repair the damage; a 10cm hole between my vagina and rectum, and my sphincter is split in two. The damage is so bad that I have been given a temporary (hopefully) colostomy to allow everything to heal. I just hope and pray that it does, if it doesn't then I will have the colostomy for life.

It's all been very hard, and coping with recovering from a difficult labour and delivery, a new born, recovering from major surgery and a colostomy isn't the easiest thing I've ever done!

Just wondered if anyone else has been through the same, and what the outcome is?

Despite everything, my gorgeous boy is worth it and I'd do it all over again in a minute for him. xx

Spud
x

[Willow2]

Mears - it doesn't appear to be protocol to call in the "bum" doctors at times like these. I was stitched up by a senior registrar who did a crap job - the consultant wasn't even called in. Think the problem is that the obstetricians are of the "we can handle it" mindset, while the "bum" doctors are of the "Yes, but we can handle it a lot better and actually really know all about that bit" view and wish that they were called in at the beginning rather than, in some cases, months later.

[Mosschops30]

Message withdrawn

[Willow2]

She might not be that far away...

[meggymoo]

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[Marina]

I am just awestruck spud at how brilliantly you and dh are handling the aftermath of your birth trauma. Ds is a lucky young man to have two such positive and determined parents ...respect.
And I thought having uncontrollable clostridium difficile squits for a month post c-section was a bum deal...wishing you all the best for a completely successful colostomy reversal when the time comes and congratulations on the birth of your son.

[mears]

spudballoo - I have seen women with 3rd and 4th degree (rarely) tears but I have never seen a colorectal surgeon called in. I am not sure of the outcomes for these women but it is an aspect I will be looking at in the near future.

[mears]

here are the RCOG guidelines for you Spud

[SpikeMomma]

Hello Spud,

Totally know how you are feeling my lovely - Had a 3rd degree tear and SPD - so i was also on crutches cos couldn't walk (lucky lass i am! - felt like a car crash victim!). It's so hard staying positive after what you've been through; it's all new, you feel ill and it's scarey wondering about your recovery. But, you will feel so much better in a few weeks. I'm sure they will have sorted you out and the bag will be gone.

Least they spotted it. I know of a 3rd degree tear which was undetected. She only noticed about 12 hours later when she prolapsed in the shower - not good.

So stay positive Spud, the stuff i have had the balls to read (been a bit spineless to be honest as couldn't face it!), has been positive about recovery. It's just getting over the shock of it all isn't it? In a few weeks you will have adjusted to it all, feel physically stronger and be enjoying your boys first smiles!

I still have me 'why me' thoughts, which i'm sure you will too, but - just look into the eyes of your boy: the best bum remedy in the world! Some aren't blessed with what we have - that's babies - not broken bums! . Keep positive my lovely. And keep smiling. This will be a distance memory in a few years. xxxxxxxxxx

[jojo43]

Hi Spud,
I had a 4th degree tear in 2002 at birth of my 2nd daughter.(No.1 was only 18 months at the time) The tear was repaired at birth, but I then had a massive bleed, 4 units transfused, and they had to push really hard on my belly to get uterus to contract. Consequently the repair was damaged. We didn't relise initially. 10 days after birth I had to go back into hospital for "manual evacuation" of the bowel as I was so constipated. Long story short: Jan 2001 I had an Ileostomy and major sphincter reconstruction. Ileostomy was temporary to allow repair to heal. I know what you are going through. Believe me pooing into a bag is a lot better than having no control at all, leaking everyday, having to wear "protection" etc. Just look at your little friend as a means to an end. Your bum will be healing nicely I'm sure. 4 years on I am as "normal" as I will ever be. Take care Jo

[lazycow]

A friend of mine had this experience about 8 years ago. She had a bag for a few months and I don't know all the details as she didn't want to talk about it at the time but I do know the bag was removed eventually and she is OK now.

She hasn't had any other children since though that is because of problems in her relationship (now divorced) rather than as a result of the birth trauma

A work colleague of mine also had a bad 4th degree tear that had to be corrected in an emergency operation and although she avoided a colostomy bag (just !) she was told that she should not have another vaginal birth and has since has another child by c-section.

[vizbizz]

Wow, you are amazing! I had 3rd degree, which was bad enough! It really does help so much having a really helpful hubby
I have a friend who was in the same situation as you several years ago. With a great colorectal surgical repair she is as good as new....says she doesn't feel any different to what she did before having a baby.

[spudballoo]

Hello again, gosh didn't realise this thread had been brought back to life!

To update. My son is now 14 months old. Alas, whilst the huge fistula repaired nicely my sphincter repair did not. Physiological test showed a persistent weakness in the internal and external sphincter, from 10-2, top to bottom. This suggested i would not be continent without my colostomy.

However, a further more practical test (involving barium and porridge up the bum!) suggested I might be continent, despite the muscle weakness.

Only way to find out is to have an operation to reverse the colostomy to assess my level of continence. That was supposed to happen in September of this year, a year after I gave birth and got the bag (so much for it being temporary!). The delay mostly caused by me breastfeeding until my son was 10 months.

But, ahem, just after the reversal was booked I got pregnant by mistake. not planned at all, i was breastfeeding, no periods etc. But there we are.

So now everything is on hold until I've finished breastfeeding no2, likely this time next year.

Who knows what further damage this pregnancy will do to my wrecked pelvic floor, I will never know really as I never tested my level of continence without the bag. I am having an elective section which should protect things as much as possible.

So my so called temp colostomy will be with me for 2 years, and who knows beyond that?

xx

[3andnomore]

((Spud))) just want to send you some cyberhugs....you have had such a difficult time there, I really hope it all will heal nicely!
a good group for support through difficult Birth

[jojo43]

Congratulations on your pregnancy. Sorry to hear you will have to keep your "friend" for a bit longer. Did they repair your sphincter after the birth, or just leave it to heal on its own? If you later go on to have a sphincter repair op-(as I did in 2003)you will have to have colostomy/ileostomy whilst it heals. My muscle is repaired, but still have "urge incontinence". I have found the best thing to be to get in tune with your body and make sure you "go" at a regular time. I thought it was the end of the world initially but just concentrated on the new baby-who is now 4 and at school.I have had physio which helped, and have my own machine at home to help strengthen pelvic floor.I was advised if I ever had more children I must have section. Good luck. When is baby due?
Jo

[spudballoo]

Thanks 3andnomore, I had found that group before but had forgotten about it so thanks for the prompt.

Jo, it was repaired immediately after birth - I went straight from the delivery suite to the operating theatre. I have had physio too, but at the moment there is nothing to done until baby2 (coming on 8 Feb) has finished breastfeeding. Then they will reverse the colostomy so we can assess my level of continence. Another repair isn't recommended, very likely I will have a pacemaker fitted for sacral nerve stimulation if my continence isn't good.

x

[jojo43]

Hi Spud, Well good luck with it all, that's all I can say. I was amazed to discover I am not the only one this has happened to! My baby was delivered by ventouse in theatre, so my tear was also repaired immediately, but no stoma at that stage.That was later at my second repair. More worrying was the haemorrage(spelling?)which they couldn't stop. Consultant had to be called in middle of night, at one point they were going to have to do emergency hysterectomy to stop me bleeding to death! Kind of brings things into perspective. We are alive and have our children-what's a dodgy bum after all?
Love and support
Jo x

[jenwa]

Hi Spudballoo
Sorry to hear of your bad time, sorry this reply is also late (I was reading another thread and it linked to this one).
I had a 3rd degree tear last year (DD born Oct 05), I did not have a colostomy, was repaired in theatre about 2 hrs after DD was born. I recovered quite quickly although it was always difficult going to the toilet and sometimes felt like my insides were on the outside (sorry to be so explicit). I feel sorry that you have had to go through all this and hope that you have a much easier time this time and that things can get sorted for you after your 2nd baby.
Do you think you will have C-sect? I have read afew threads now on tears and am now convinced to have one next time as too scared to become incontinent if it is likely to happen again.

Good luck

[VersoWassailWassail]

(((spud)))
Just saw this. Congratulations on your pregnancy. How you managed to get pg again with everything - er - going on down there I don't know!!! You won't remember me, but I had a third degree tear and internal lacerations in April 05, with bowel incontinence for the first few weeks of DD's life and lengthy physio sessions and ultrasound etc to assess my level of continence. You have my utmost respect, and good luck with the birth!

[mears]

Spud - I asked this on your other thread. Why does reversal have to wait until you have stopped breastfeeding?

[spudballoo]

Hello again!

Erm, it twas a VERY large and strong Pimms which got me pregnant (well not literally but you know what I mean). Believe me, bedroom antics with a colostomy bag is errmmmm a very rare thing let's put it that way!

Mears, I have stop eating for 48 hours pre op and have nasty stuff to clean out the bowel completely. then, post op, nil by mouth for a bit and then only clear liquids, then liquid foods etc. Chances of my supply keeping going through that are virtually nil. Even if I don't BF for as long as with no 1, I need to be totally recovered from the section before comtemplating another op.

Oh, yes, i am having a section under strict instructions from my colorectal consultant!

I had more bad news yesterday, I'm feeling dreadfully unlucky at the moment. A routine scan (I'm 30 weeks) with my consultant has turned up a very rare brain abnormality with my baby. We're devastated, and are seeing Prof Nicolaides at the FMC on Wednesday.

How unlucky can we get? Yesterday was hideous. I went to the appointment on my own, and thus sat sobbing in the FMC waiting for an emergency specialist scan surrounded by couples...waiting for my H to arrive. Then sobbed my way through my Tale of Woe to the sonographer as I had to explain why I have a colostomy bag. Hideous. Reliving nightmare birth one while having baby two's wonky brain scanned. Sob sob.

x

[DoesntChristmasDragOn]

Oh, Spud... did they say what the abnormality might mean or won't they know til Wednesday?

[Willow2]

Hi Spud,

So sorry to here that you are having a hard time... again. You know my email if you want to natter. Thinking of you and hope meeting with the Prof goes well. xxx

[VersoWassailWassail]

Hi spud

Why is life so unfair?! Is there any possibility the brain anomaly might be a mistake? Or nothing to worry about? It sounds serious - but then anything with the word 'brain' in it always does. It just seems so hugely unfair for you to have this to cope with on top of the colostomy.

Hope it all goes well with the consultant.

((hugs))

[GillRuth]

Spud,

I am so so sorry to hear about your scan.What terrible news.I hope the top man (Prof Nicolades) can help.You are right no one deserves to go through what you have - I'll be thinking about you. (hugs)