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Share experiences and get support around labour, birth and recovery.

I have a spearated abdomen, also called 'Diastasis Recti'

207 replies

honeydew · 20/04/2008 22:08

After giving birth to my third child a year ago, I have a post partum condtion known as 'Diastasis Recti' which means my abdomen has separated due to pressure on it from my uterus. I have had large babies in quick sucession. I have had 1 vaginal birth and 2 sections (1 emergency) I have to have major surgery next year as my body will not heal anymore by itself. My abdomnen needs stitching back together, my umbilical hernia popped back in and I get a free tummy tuck thrown in! I still look 4 months pregnant, have to wear large flowing tops or maternity clothes and am often in pain.It's not easy when you have three children of four and under to care for! My surgeon says he sees cases like mine every other week. Is there anyone else who suffers from this debilitating problem and what have been your experiences?

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Jammybodger · 31/07/2009 11:25

And don't forget to draw your stomach muscles in whenever you think about it and keep them there until you can do it for an hour at a time or more! It's a great exerciser and strengthener which can be the first step in a DR tackling regime!

Posture also, as if there is a string from the top of your head to the ceiling, keep it pulled up so that your shoulders don't round. The stomach flattens when your work on your posture and draw in the stomach at the same time. The effects improve without bloat. I replaced junk, alcohol and stodge with rice, nuts, seeds, yogurt, fresh and dried fruit, fresh and frozen veg with a little cheese and meat and choc, it has made a huge difference. More difference than the hernia op!

mustsleep · 31/07/2009 13:09

thanks Jammy have been trying this just to suck my guts in really didn't know that I was actually exercising lol - will do it even more now

Have also been trying the Tupler technique before op - and big pants to hold it all in help, and also support your back too

honeydew · 31/07/2009 14:01

Generally, there is a great deal of confusing about this condition both here and in America. There is an American support thread called 'PEER TRAINER' -Diastasis Recti where you read about other women's experiences.

What we all have in common is that we are all having very different experiences and treatment of essentially very similar problems.

There appears to be ignorance surrounding the condition within the medical proefession. The NHS have not clearly informed me at all about 'Diastasis Recti, 'diverification' and the difference between abdominal reconstruction and an abdominoplasty.

Plus I have an umbelical hernia which complicates the issue and affects what type of surgery is open to me.

No doctor has ever given me a list of treatments both within the NHS and the private sector so that I can choose the best type of surgery for the most effective, long term result.

If you don;t ask, they will not help you. They just rush you through the system and you could be left with your mummy tummy and / or facing another operation.

I should have had my hernia repaired last year really but I did postpone it because I had a baby and was still breastfeeding.

No doctor said I could should look at having two operations- one the hernia and then a tummy tuck at later date if it was possible.

I myself am still very confused and have postponed my surgery for a few months. I want to be seen again and further assessed, perhaps a scan of my hernia and possible keyhole surgery.

Bascially, my understanding of umbelical hernias is a s follows:

a) If you have a large hernia ,then they will use a mesh. That mesh will be attached to the abdominal muscle on both sides, so effectively the mesh is in between the muscles. Thus the muscles are still slightly apart, so you'll still have the tummy bulge.

b)For athletes and people with an active lifestyle- the mesh should be placed underneath the muscles and then the muscles tightened up so that the gap is effectively closed and you tummy flattened more.

But - if you have Diastassi Recti or diverification? ( still not sure what that is yet!), the muscles may be too far apart for the mesh t underneath or above the muscle so in between is you only option. This is true apparently , if the muscles have effectively shredded out to very little. There is even a 1% chance that the hernia will be inoperable and you have to have another, more complex procedure to correct the problem.

Most doctors on the NHS seem do the mesh in between as it is easier but you are left with bulge.

I am going to write to my surgeon today to get all of these issues clarified and then make a properly informed decision as to which surgery will be the best for me.

With my hernia AND DR the only option for me might be the original operation I was on the waiting list for- the open hernia repair and a little nip and tuck here and there!Because of the hernia and the way it will be repaied, I may not be able to have a tummy tuck as there may not be enough muscle to sew completely together if it's a severe separation but I have no idea for sure at the moment. If a tummy tuck will never be an option for me , then I'll have the NHS surgery and be done with it and live with the bulge.

However, if I can have keyhole surgery and then the rectus muscle tightened after a year two plus all excess skin removed then I'll consider that.

I haven;t had a scan since last year, so I'm going to ask for further consultation. I have not been examined by my surgeon for a year either, so I want to be seen by him and I'll take his advice. I don't think the NHS removes the C-Section apron hang either (the pannus) so I want this clarified.

My DH and I also want to explore having say the hernia repaired on the NHS but all the excess skin removed by paying privately so my operation is partly a tummy tuck in that repect. I don't know if this is possible but I want to explore it anyway.

I do understand that they can't tell quite how big the hernia is and how they will operate until they open you up to have a look. So I expect some women with smaller hernias and muscles separation get a better result for abdominal NHS reconstruction than others.

I will post back with what the surgeon says.
I want to look at all options first before going ahead with my original NHS operation.

I know that hugetum had very large hernia and was successfully operated on and I'm so very pleased for her. But it does look as thou they have stitched her muscles fully back together which make all the difference to posture, look and comfort. I know getting rid of the hernia will be a huge relief.

I just need to find out if I can tackle it as a separate health issue through keyhole/open surgery and then in a year or two get the cosmetic issue of the DR,pannus and loose skin dealt with through a tummy tuck.

I hope this makes sense! I think I would rather pay for a proper tummy tuck if that is the best route.

To be honest, I am still confused as to what the original operation was. I did think it was the same as hugetums but I found out at the last minute that this was not the case.

I was down for a hernia repair, but that the plastic surgeon has a little bit of scope to cut off some excess skin but that's it as the NHS do not do abdominoplasty's. The DR is considered cosmetic.

As hugetum said, if the NHS are not going to tighten my abdominal muscles, then my best option is the hernia repair only and a private tummy tuck later where they WILL stitch the muscles together and get rid of ALL the loose skin. So I'll get a better result.

But if they look at me and say no, the hernia is too large and the separation too wide for the muscles to be closed completely, then I'll put myself back on the waiting list for another 3 months and have the original operation I was scheduled for and just live with a smaller bulge.

So no, you don't have to have two operations, but it SEEMS that if you want those muscles tightened as well as the hernia repair, the NHS is not going to help most people achieve it.

Of course it does depend on your medical history, level of DR and herniation ( if you have it) so I can only speak for myself on this thread.

OP posts:
honeydew · 31/07/2009 14:13

yep -me too- I'm going to start sucking my guts in and eat more rice, nuts ,seeds etc. Wheat defintatly bloats me out even more!

Can't cut out booze altogether but will only have wine at the weekends form now on. It's unlikely to cure the problem but I can sure try to help myself and strengthen my abdomen so that when I do have the surgery it will be a quicker, easier recovery.

I want to work on my posture as well - the DR and hernia pulls me down so I'm going to practice standing straighter and small exercises for my upper body that keep my shoulders back.

thanks Jammy- how long was it before you noticed a difference? You say it has helped more than surgery? I so wish my hernia would go away!Bloody thing!

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honeydew · 31/07/2009 14:24

to kin 11.

yes i see your point, but ehat i think you've seen is an abdominoplasty, not a hernia repair.

In the former, yes they bring the muscles together which should push the the hernia back in ! The rectus muscles are tightened and the the excess skin cut off -ie tummy tuck.

But the NHS won't stitch that muscle together as they view it as a SEPARATION of muscles not a tear and is therefore only cosmetic.

Because it is not a medical necessity to repair it, they won't do it. Does that make sense?

Only the private abdominoplasty will get you the muscles tightened. I would LOVE to be wrong and that you could get the full abdominoplasty on the NHS but it appears not.

I possibly could get the hernia and full abdominoplasty done all at once if I went privately. But I don;t have the funds for at least another 2 years my hernia needs repair as soon as possible really and the NHS will help me in this respect.

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Jammybodger · 02/08/2009 21:57

Hello, just been away for the w/end. I had a HUGE hernia repair, 7.5cm long, vertical from under ribs to tummy button ( they said they could have gone all the way down to my bikini line, my bulge was so bad, 5 mths pg look).

My DR was so bad and my back so weak with it I lost the use of my legs for a while.

Anyway, a hernia repair does not stop the bulge (much to my disappointment) but it did stop the guts protruding when I go on my hands and knees.

What truly helped? I'm going to be brutally honest now. Shifting the tummy fat! I don't think surgery is the best way for that either, too expensive, invasive and puts you out of action for a long time.

I did it the hard way. Do not want to put people's backs up about this as is hard when bfeeding/young dc, little time/money etc. But crucially it can be done if you devote 20 mins 3x a week just to get into some good habits.

Personally, I think bloat giving foods and drink has a lot to answer for so I'd be quite radical about that and get them out of the house for a 6 wk trial period so you don't get tempted. Lidl is a good source of cheap sunflower seeds, pumpkin seeds and walnuts.

You just need a small sprinkle once a day with some yogurt and chopped fresh or dried fruit. That really is my only dessert on a day to day basis.

As I no longer eat wheat I have ryvita or rice with a small amount of cheese, veg, eggs, fish, meat etc, Thai, Chinese, Japanese, Indian are great but again, a wide variety but everything small/in moderation.

The rest of what I eat is as much fruit and salad or raw or cooked veg as snacks so it is unlimited really. Then always some choc and may be a glass of wine or Bailey's as a treat.

This diet plus the walking which then turned to jogging (never more than 20mins at a time so you don't get disheartened and give up)and definitely not every day (I'm too lazy for that!), plus the posture and tummy drawing in all the time (whenever I remember, I'm even doing it now!)and I'm sure you will start feeling the benefits quite quickly.

I read somewhere that photographing what you actually eat helpful (if a little extreme!) but it might help those for whom dieting never seems to work.

Basically, I'm so used to holding in my tummy now that it feels natural and so most people would not know I have DR so it's good for my self esteem. I'm sure the nuts/ seeds have something to do with my mood as I used to be alot more depressed than I am now.

Basically this option is cheap and cheerful and if you do have a go I'd love to hear about it.

Jammybodger · 02/08/2009 22:17

Whoops! Forgot to say I started noticing a difference within a week of starting the jogging/cutting out stodge).

After 2 months quite dramatic change. Would definitely look good in a bikini now!(but can't because of scar)

mustsleep · 03/08/2009 11:03

Jammybodger I've just has a hernia repair not quite as drastic as yours but how long was it unil you could exercise afterwards?

Have you done any situps or just he drawing in of the tummy muscles?

Jammybodger · 03/08/2009 12:47

Mustsleep, could not do any sit ups whatsoever because of strain on back so had to devise other strengthening/tightening methods, and what I've outlined was good for me.

Also, lying down and drawing tummy muscles in and then bending one knee (not lifting) one at a time helped because you can feel the DR muscles working without putting any strain on them.

Swimming is also great (I also ride but don't know how good that is but sitting trot certainly is good for the tummy muscles)

You must only do little at a time and what doesn't strain at all, so I was holding in tummy muscles practically straight after hernia repair and found sit ups too much even 6 months after so don't bother with them at all. I have a bit of a fear that the hernia repair may fail which is why I don't like to put any strain on it.

As I have found, you can get a nice flatter tummy again without doing anything drastic. Seeing women runners with pancake tummies is evidence that running seems to prevent a build up of a fatty middle layer, and again a little and often has worked well for me.

I like the fact I can hold my tummy in and work on my posture at all times no matter what I'm doing, even gardening and as a result I haven't had the back problems since either!

mustsleep · 03/08/2009 20:24

thanks I am going to give it a go!

I daren't hardly lift anything at the mo lol, just been for my pos op and have been old to ake very easily so I think it may be some time before I can do much

when you say bending one knee what do you mean not raising your leg at all?

Might try the trampoline also as it's just there begging to be used

honeydew · 04/08/2009 17:57

I am finding that even after a week, eating more seed, probiotic low fat yoghurt and cutting down on wheat is helping my digestive system. However, I'll wait to exercise until my hernia is repaired and then take it slowly.

Thanks for the advice, I am snacking on dried apricots at the moment. My diet needing improving anyway but it's hard to concentrate on yourself with young children around.

The lady at the fish counter asked when my baby was due yesterday which always gets me down but she did compliment me on other things so I feel just about ok. I had really no idea just how much of a devestating effect on me this condition would have. I cannot believe that it is so little known about.

It is never mentioned in leaflets or information on pregnancy to my knowledge. I honestly did not know that you could get a hernia through having babies! Was I ignorant?

I do wonder why my GP didn't warn me after my second baby and make it clear that after an emergency section I should leave at least 2/3 years before having another. I would have taken good advice!I'm not blaming him as such, but I just wish I'd known the facts, complications and dangers of having kids close together.

I may have to live disfigured all my life and I'm worried I never be able to have an abdominoplasty to flatten my stomach because I am too torn.

Hope you are recovering well from your op mustsleep- it'll be my turn in 2/3 months!

OP posts:
honeydew · 04/08/2009 18:00

Just to add- I wouldn't be without my kids though! Love them more than anything.

OP posts:
mustsleep · 05/08/2009 17:17

honey though it could happen with out a section though anyway, I have never had a section with any of my three!!

honeydew · 05/08/2009 18:50

hi mustsleep- did you have big babies? All mine were big and I have a small frame.

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Kayugaduck · 06/08/2009 08:10

Hi! Hope you are working on your posture and holding tummy in! I've been doing it too after my hernia repair last week.

My 4 were huge babies and I've a small frame too which is why DR was so noticeable.

But we mustn't be disheartened.

Found a nice way to have a sprinkling of nuts and seeds, on a bed of leaves (got mine from the garden but grow some in pots too for ready supply)lettuce, beetroot, pak choi, spinach with a dollop of salad dressing. Have that as a light lunch now or part of dinner.

Went for quick jog/walk while everyone was sleeping. Dh says it's a good time to go and anyway he's encouraging as he likes my new found 'lift in mood'!!

mustsleep · 06/08/2009 09:47

Hi honeydew I have a small frame too which makes it look worse for me to be a size 12 iywim as I seem to carry it all at the front

I don't think any of them were paricularly big though, the biggest was 7lbs 11oz bu I was massive while pregnant, had a lot of water lol

well at leaast I have ended up having the summer hols off work lol might have to string this out a bit and make the most of it

am properly starting the diet on Monday, going to give weightwachers a proper go

Have been doing the pulling the stomach and think it must be working a little as I feel achey by bed time

going to start some gentle exercise next week, avoiding situps of course (don't want to undo my hernia op do I) might try a bit of yoga and going to start walking every day again

IT WILL WORK!!!!

madzdaizy · 02/09/2009 16:48

hi there you said you have a tummy tuck thrown in i was just wondering how you got them to do that and what i should say to my doc to get the same because i have just been to the doc and been diagnosed with the same thing but the doc said they will do all the inside surgery but they wont do the snip of the skin which i would really like to get done as i was saving for a tuck but due to my problem cannot have it done now as ill be having simular on nhs and its not a good idea to have it done twice

nomorexcuses · 15/10/2009 21:42

I'm a specialist postnatal personal trainer & have just been blogging on this subject - there's a couple of posts here which might help? Blog Here(No sales pitch - just some free information from someone who has helped put lots of split tummies back together again )

kim111 · 27/10/2009 13:53

I'm thinking of having a DR repair operation hopefully next year if I can afford it and I have a couple of (slightly weird) questions for those of you who have had the full repair ie. muscles stitched together.

  1. What happens if you eat a lot in one go eg Christmas dinner? Is it really painful? Can the repair come undone?!

  2. After the operation are there any bladder/bowel issues? I had twins and was very surprised to have no bladder/pelvic floor problems but I'm wondering if that's because all my guts are sticking out at the front rather than being pushed down as they would be normally....

I would be really grateful if anyone could help me with these questions either on this thread or by messaging me. Thank you!!

hugetum · 29/10/2009 21:51

Kim111

Hi, l had the full op in June both Hernia and DR. The only time there is a risk of it coming undone is if you became pregnant. I have been advised not to do any stomach exercises for at least a year, esp crunches thats a no no. Gentle walking/treadmill is ok. If you overeat day in day out over a long period of time...then it will affect your stomach....., l think occasional over indulgence happens. I have found that l try and not to eat carbs after 5pm...it has made a vast difference to my stomach..there is no bloatness.

I had revision surgery a fortnight ago, just to remove excess skin (dog ears) and tidy up the scars. I am happy with my look. It will never be perfect...washboard stomach...but hey considering what l looked like before the op...l am eternally grateful.

Yes l too had all my guts hanging out, and in the first week after the op l felt really strange and felt alot of pressure down below both front and back passage. I felt so scared to visit the loo in case something was pushed out. I was soo concerned that l went to see the Dr. She explained that as half of my overstretched stomach has been removed, it is natural for the body to take time to adjust, especially when the same guts had to be squeezed back into a much smaller stomach. I have to say after 3/4 weeks l don't feel the pressure anymore..it has settled down.

The last week or so..l have been hitting the shops...to buy nice clothes which are not maternity!!!!!...it felt really good. I carry a picture around with me of what l looked like before the op....l never feel down in the dumps anymore.

Good luck with the op

kim111 · 30/10/2009 20:35

Hugetum, thank you so much for your reply, it has really put my mind at rest . I'm really glad your surgery went so well and am getting excited about the thought of some normal clothes myself now!! I have one more question though - how long before you can exercise properly? Not sit ups or anything like that but just say playing tennis or something?

hugetum · 31/10/2009 14:25

Hi Kim11,

I am no expert, but l was advised not to use the treadmill until after 3 months, just listen to your body. As for tennis...that is really strenous, remember the nature of the action...you will be pulling on your oblique muscles on the side of your stomach, it could have a bearing on the muscles that run down your stomach. Try not to put a strain on your stomach...otherwise the stiches will come apart. It can take up to a year for healing to occur...before you contemplate building up strength in your stomach muscles. Apart from lifting up my 15mth son and general housework, anything else which involves involving heavy lifting ...my hubby can do it!!I have noticed that lm cannot run yet...you will feel a strain on your tummy..l just walk on the treadmill.

kim111 · 01/11/2009 13:46

Thanks for the reply Hugetum, at the moment I can only really walk and cycle, I don't even dare do weights in case the wrong movement opens up my stomach even more. I guess I was hoping that within a few months of surgery I'd magically be back to my pre-baby body! Do you think that after a year of healing then say a year of stomach strengthening everything would be back to normal or do you think the stomach area would always be a weak point?

hugetum · 01/11/2009 18:57

Hi Kim111,

I am not sure, l think the surgeon would be best to advise you. I would just try to look after it the best you can. I am sure you can resume normal activities. It is like with any surgery..you would not put extra strain on that area. I am sure you will be ok.

kim111 · 03/11/2009 23:04

Thanks for replying again Hugetum, I think you're right, oh well at least one day I'll look normal again!! Thank you so much for answering all my questions

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