Mid wife shrieking in horror at extent of open epistiotomy wound. All stitches undone, severe infection, any natural remedies anyone?

[Dhosonia]

1st time poster - Before starting i just want to say that i have tried to read every related post on the topic on mumsnet and elsehwere as i dont want to waste ppls time and effort but cant seem to find the answers that will help my wife anywhere. She is not posting herself as i am trying to burden the pain for her and think that the less she knows the better frame of mind she will be in and therefore cant get caught up in a cycle of negative pessamstic thinking. This was our first son - pessary/pitocin drip/epidural/epistiotomy/forceps. Was a wonderful pregancny but traumatic birth (28 hr labour) I feel very guilty and im blaiming myself for the mess wifes in now, as i was so wound up about the forceps scar after telling the registrar that we didnt want it (baby was in correct position, all stats ok for mother and baby) that i started having a go at her whilst the registrar was still stitching after birth saying that we didnt want forceps - look at his scar etc as she only let her push for 40 mins and cited maternal exhaustion as reason for forceps etc. so ive concluded she did a terrible job in stitching after i upset the registrar with my outburst. The room was also like a circus, 4 mw's 1 reg,1 nurse, 1 ped.

All her stitches have come undone and there is a horrible gaping open wound with pus and all sorts of gunk seeping out intertwined with whats left of her stiches. Birth on 27June back in hptal on 1st july. IV antibiotics - they cant restitch - offered possible repairin 4 - 6 mths. Whilst in hpital any mw's that checked reacted with horror when checking her wound. Back home today 6 july. Mw reacted with horror again at seeing it, cut is right from top of vagina to the rectum.

Its very severe and my wife is in huge amounts of pain. When showering to keep it clean should the water go inside the wound? or just softly outside. How long should she sit on the bidet - 1 min - 5 mins? Can i put manuka honey on it now or will it hurt to much/sting/cause bad reaction/make it worse. Does it go inside or just outside. The odour is going but its still full of white and black thimgs inside and is pinkish. Can i spray collodial silver on it? How long is healing time.

Thanks you for any replies we are totaly lost on this and seeing how much pain she is in is breaking my heart. Also have switched to combination feedimg as we dont want antibiotics getting through to son - is this a good idea?

I think medical staff should be held responsible for their incompetence when it comes to episiotomy; but I realise that this is not always the best way to heal the trauma of somebody who has been cut like this.
Many midwives believe women should tear naturally, because a natural tear is jagged, and can therefore heal more easily. An episiotomy is a slice, so it's much more difficult for it to heal. I tore naturally all the way up inside with my first, and it healed fine, without any stitches. Episiotomy is a completely different type of tear.

Midwife research suggests that in the US, where episiotomy is practically universal, women are much more likely to suffer from third degree tears than in countries where episiotomy is less freqently used.
I think there needs to be some proper in depth research done on the validity of using episiotomy at all, except in vary rare instances.

Sorry for the long post. I'm angry on you behalf that medical staff can be so lackdsadaisy about this

Sakura inm my case an episiotomy was essential as I had a forceps delivery and the baby was very high up- hadn't descended much at all after 3 hours of very painful pushing with no pain relief!

I do agree that episiotomies can be carried out too readily though. but I think things are changing in this country, in the 70s they were routine but its becoming less so now from what I gather.

Thanks for your support.

I does sound like it was necessary in your case. 3 hours of pushing is a lot, and if you didn't have pain relief then there would have been nothing slowing down the baby's descent.

My rip inside took a while to heal but women's bodies are truly amazing and they do spring back. Soon you start enjoying sex, then you start thinking about another baby .
But anyway, take your time, no rush. It was only about 10 monts after my first baby was born that I felt like having sex again.
Second baby: after about a month!

Thanks for your message Sakura it really does give me a boost to hear such stories, and your post made me laugh!

Im kind of hoping that people post up stories like this and give me encouragement here as I really need it right now, I'm in quite a bit of pain. Since I had the wound cauterised last the pain lessened but now it seems to be returning again.

Hi Everyone to any ppl still following this thread i originally thought it had been deleted as there was a concurrent thread running in the birth injuries section (only posted there as a poster right at the very begining said to post there)i didnt realise it had been moved until someone in the birth injuries mentioned it, i have not done a "runner" even though some of the mega feminists who were "creeped out" at me posting and not my wife were peturbing but as someone mentioned above my wife did not want to post (rarely uses the net other than for work etc or shopping! only joined facebook this year etc) and with the amount of pain she is in it really was the last thing on her mind so i took the iniative and posted for some advice/shared experience stories etc when talking about the posts and me encouraging her to write/read she would retort that ppls shocked reaction would just make her think "oh shit is it really that bad" etc and didnt need that at the time.... moving on...

Most of the advice has been fantastic - as a massive believer in herbal remedies (having had a chronic illness myself which was cured by a naturopath much to the huge disbelief of the medical community)i fought every instinct into going down that road with my wife on the advice of most ppl on this board and have gone down the medical route - before any radical bra burners say "you fought every instinct - what do you mean you - surely its her decision" My wife is very ill/in massive pain very scared and totally reliant on me as she cant even get out of bed and with breast feeding/changing nappies/holding the baby/cleaning herself after every poo/pee/applying medicine/dealing with baby thrush/baby acne/her own infection which now also has a urinary tract infection and possible blood clot in her leg....she wants me to help her as i am her HUSBAND and want only whats best. I also at all times respect her wishes, and do what she asks of me...i will offer an opinion which she will say "shut up/get lost/i'd rather jump of a cliff" to and i will peacfully accept! as in a normal relationship mutual respect and understanding will have you doing that!

Sorry off on a tanget - she has been on antibiotics for almost a month, the wound has drastically reduced in size but is still very painful/semi granulated/not closed up yet. The best piece of advice proffered was to see a TISSUE VIABILITY NURSE. I brought to her attention Aquacell dressing as was mentioned by another poster and although she had never used it before after doing research she said its the best thing for it - and has helped close the wound. We may well put a tiny bit of manuka honey on it to try and minimise the scarring - the TVN highly recommended it but to be very judicial in its use as it has a very high sugar content and can cause very bad thrush. Bye for now and thank you to all the well wishers and a small boo to all the haters who are still sort of nice as they have still proffered sensible advice and taken the time to respond.

I'm very glad to hear that it's reduced in size, and sorry that it's not closed up yet. It sounds like a very hard time for both of you, and gosh, your poor wife now dealing with a UTI and blood clot on top of all of this, how horrendous.

But "radical bra burner" and "mega feminist" still make you sound like a dick, I'm afraid. Which is a shame, because I'm sure you're not - maybe next time you're feeling defensive you could try not to resort to sexist insults?

I haven't posted before on this thread but wanted to say I totally understand why your wife wanted you to post and look after her. It sounds like you're doing a fab job in a traumatic situation and she's a lucky lady (husband wise, not birth experience wise!). Hope your little one is doing well too and that things are settling down for you now.

Sorry, just come across this thread and not read the whole thing. What did come out from the first page or so was the emotional pain you are both in, though hopefully that is easing now. What it brought to mind was the homeopathic remedy Staphisagria which comes up a lot after birth with the feeling 'How could you let them do that to me' type of feeling. It is a big remedy for suppressed anger, anger which you can't or won't express fully.

I'm not suggesting that you just go out and get this but do do some research into it. If it feels right, it could make a big difference in helping both of you to let go of some of the anger that you are both experiencing through your own sense of powerlessness. Given you have seen a Naturopath in the past, it might be worth getting in touch with them again to help support you as you support your wife and child.

Oh, and congratulations.

[Dhosonia} iloved your post! im so glad you found the thread abd responded to the meanies who were saying some nasty stuff. for what its worth, my hubbie read your post and the look of just absolute empathy for you was profound. he said he totally knew what you were going thru, ie what YOU were going thru as he was and is in the same position. we both wish you well.

im wondering if its 2 late 4 me to get a TVN as im now under a gynae drs care? im going to see him agaiun next week probably 4 the granulation tissue 2 be cut off as cauterising it doesnt seem 2 b enuf.

Hi M28 this is Sonia my Hub has suggested i read/post on this as im slightly better, fisrt of all a big thank you to all the ppls that have responded and written, i was almost in tears reading the responses and the time and effort put in by ppl, especially sharing their own stories, life is hectic and any time taken out to help anyone else is merciful and kind so thanks.

Im glad i didnt read this during the early stages a month ago when, as lovely and caring and sympathetic and empathetic ppls responses are and full of good wishes some of the posts where ppl are literally shellshocked as to what happened made me think that perhaps what happened to me was a one in one million scenario and got me quite worried but at the one month stage and seeing and hearing about a lot of other stories has made me realise that im not the only one in this boat (im not far of, the hospital consultant who is very honest said that out of 7 thousand births there every year they only see wounds to my extent once twice a year, as opposed to the midwives who kept saying its absolutely normal, common, dont worry et al which again might me them trying to put my mind at ease so i bear no grudges)

I think you can ask to see a TVN at anytime, we were met with responses like, why do you want to see a TVN, the consultant said leave it! but thanks to my Hub and a few good local aftercare community midwives they located one and the treatments and care have helped immensly, Its better to know that you are trying your best rather than leaving it to the hands of fate or rather the outstreched understaffed underqualified unsupervised NHS who got me into this mess in the first place!

If you have been cauterised you have healed and the gap is closed so im not sure how much the tvn can do but they can surely give a second opinion on how to treat the granulation overgrowth. Pls let us know how you get on, on a side note having read what my hub has been writing (bless him he's befuddled at the best of times) and some of the responses suggesting he is a control freak and i am some subservient simpleton nothing could be further from the true, just makes me laugh how ppl can make judgements on message boards on little to no information even when someone is trying their best to help (i.e dear hub) in a distressing time, my love for my little family of three has gone through the roof during this time, i would not change him for anything in the world (except Enrique Englaisas (~swoon~). I am still in massive amounts of pain and try to maintain a quiet inner strength as i know i just have to be patient but again thanks to everyone i will leave the follow ups to my hub and try and try and check in once in a while when ds allows me and all the aches and pains are having a little nap x

Hi Sonia, I've just realised why your DH has the name he does on here I think you sound really brave, I know how traumatised I felt after an unplanned c-section and so can imagine a small amount of what you're feeling. I just wanted to let you know I thought your DH sounded very caring and worried and I would hope my husband would react in the same way should I be in a similar situation. Best of luck to you and your new family x

Sonia, hi, huge congratulations on your gorgeous little son. I'm so sorry you had the birth experience that you did, but it sounds like you're healing now, and that's great. It's such a hard time even usually that I can't comprehend how much harder it must be when you're dealing with the pain that you've had. You're doing brilliantly, and as a family you sound very strong.

Your husband said you weren't much for message boards, but you're always welcome here when/if you feel inclined. When we're not being judgemental we're quite nice, I promise.

Sonia, its so good tohear from you. I know youre not gonna read this for a little while when the pain takes a nap (love that phrase, i felt that way too...now its a case of the pain free moments takinga nap...which is a good sign it means thingsare getting better)

i see what you mean, it probably is too late for me to get a TVN,i wish i knew about them ealier but never mind. the wound is still not closed andam still in quite a bitof pain but i think i'm nota different path of care now.

incidentally i am also seeing a reflexologist which is really making me feelgood and she is doingsome stuff to reframe my thinking to keep me positive. ive been really lucky to avoid any PND or baby blues0- whic h is AMAZING given whative been through but its good have some positivity induced into me too!

also i gota mobile hairdresserto cometomy house andgota hair cut,i explained to her that i can'tsit for long andshe didn'tmind megetting up every now andthen to rest my pelvis and lower back (ive got a yoga position for this purpose) and i have to say it really made me feel good. you can find one on yell.com just search for mobile hairdresser i think you should treat yourself to a bit of pampering

Dhosonia - Once your wound completely closes, use this gel to decrease scarring: Contractubex. It is used for all scar tissue but especially after gynecological operations, including episiotomies and even mastectomies. Its main ingredient is onion extract which apparently prevents excessive scar tissue formation.

I had extensive scar tissue following episiotomy that was painful to touch for about a year. The aesthetician waxing me was scared out of her wits the first time she saw it Gynecologist proposed to do an injection that would kill the nerve passing there (so I wouldn't feel anything around my vagina? ). A woman gynecologist who has suffered a painful episiotomy herself then recommended Contractubex to me. Scar was smaller, less raised, and painless after a few weeks of religiously rubbing it into scar tissue day and night. I can't recommend it highly enough.

Hi this is dho sonia she is massively unwell again, it seemed like she was on an upward curve feeling better but ironically from the day she posted she has been in massive amounts of pain she has been on Co dyamadol, diclofenac, nyarix? paracetamol etc but nothing seems to work, she s been in tears from the pain for a few days and can t even walk get outta bed its that bad - dr was useless - "this is specialist stuff, i can give more painkillers etc but you need to see your consultant" she is not fully closed yet - the tissue is still red raw and is starting to come out of the hole/tear instead of levelling out - is this scar tissue? thanks cotez - obviously she cant use the cream yet as it still looks like red raw bloody granules - how the hell did you cope for another year? it hasnt closed up completely - is there anything else she can do to help it close - i think she is in so much pain due to the over granulation - its like the tear has developed a flap of loose skin which is incredibly painful - cauterizing? cutting? she wont stop crying i think its all getting to much for her now - any ideas if anyone is still following this thread?

Sorry, I don't have any advice, I posted on your other thread and I have actually thought of your family since and hoped things were hugely improving, sorry to hear how hard your wife is finding it right now. I really hope it all gets better for you all soon. There muct be a professional that can be of some help to her. If the dr is saying this is specialist stuff, then can't he recommend a specialist?

Dhosonia - It is not normal for her to plunge back into agony. You need to take her to a gynecologist straight away. Today. Please don't wait. If wound is not closing and there is excruciating pain, there might be a raging infection there, which would lead to septicemia if left untreated. If infection responded to the antibiotics she was taking, pain should be better by now and wound should be closing.

I remember crying all day from the pain so do sympathize However, I started feeling better in the third day of antibiotics. I am worried that this is not so for your wife.

My wound had closed by week 2 or so and I could sit at the end of week 3. Your wife sounds much worse. That area was painful to the touch (i.e. Sex very difficult) for about a year but that is when the wound was completely closed.

Apparently what happens in such difficult scar formations, especially after infections, is that tissue grows with an excessive "connectivity" making it harder to the touch and mangled nerve cells making it painful. You need to cure the infection asap and deal with the scar to minimize this.

On second thought, I would actually take her to the A&E at the nearest hospital, today.

so sorry to hear about this, you two. i think you know that cote has given you good advice all along, so i wouldn't wait longer before seeing someone.

hi dhosonia

imso sorry to hear your wife is getting worse. has she been getting more active lately? i had the same thing happen to me- at 5 weeks i started to feel better and then over exerted myself and then had a real setback with lots of pain once again. it was really hard to take.

however it wasn't due to an infection for me,they thought it was and put me on antibiotics but then later the swab results came back clear.

apparently the granulation tissue is best dealt with by cauterisation but in my experience you should get it done by a gynae dr not the GP my GPdid the first cauterisationfor me and to be honest there was only a slight visible difference and the pain was no worse/no better afterwareds. however once the gynaecologist cauterised the wound there was a big visible difference and it healed ata much quicker rate.

be prepared though that you may need to do it more than once- i'mgoing back to the gynae dr this week and he will probably either cauterise again or he said he might consider cutting it (ie the granulation not the wound itseelf) under local anaesthetic.

btw, under nHS choose and book you can choose which hospital you go to, so do your research. i've actually been able to get private care under the NHS under this scheeme.

this is a tough time, i think of you a lot as i feel my family and your family are going through this together.

muslimah - for you, too. I hope you get better soon.

Hi thx for the responses again means a lot that ppl are still following this thread/thinking of us 6 weeks on, i managed t get an emergency apt with the senior consultant who deals with this and has been seeing her yesterday, he basicaly said yes there is overgrowth of tissue but he has no idea where the pain is coming from, seems to think it could be back pain shooting into that area or remnants /side effects of epidural pain - said he would not consider cauterizing or trimming that area for at least another 6 weeks. From reading cotez etc above it seems its new nerves that are forming albeit misjangled formation and the pain is spreading around the upper thigh/ genital area. The consultant was denying this and saying that she should not be in that much pain and was basically saying its all in her mind she has anti natal depression. This has crossed my mind to, she refuses to admit she hs "gone loopy" and is solely saying that the pain is getting to her, her moods etc do fit in with slight depression though and she completed a highlands?

Could the pain be excaberated because she is feeling so low so is feeling every twinge that much more? also does anyone know of any topical pain relief/numbing sprays that i can spray onto the area? Also COTEZ will the scar cream you mentioned work on an indented forceps scar? Poor lad still has a scar. Muslimiah hope you get better very qucikly, its horrible suffering so long, how long has the wound been there? did suggest haircutting to her and she snapped "you want me to look glamourous - at a time like this! go away now!" or something to that effect. She obviously got the wrong end of the stick due to her moods. Bye for now

Dhosonia - First of all, forget "Pain must be psychological". More likely, episiotomy cut a nerve and that nerve growth is now mangled in the scar tissue. I'm assuming you have seen the size of that wound in her most delicate parts. You cannot imagine that pain.

The depression comes from the pain, not vice versa. That kind of immense, relentless pain is like endless torture, and it is normal for a person being tortured to be depressed. You can't think, you can't hold a decent conversation, there is only the pain Please don't doubt the pain your wife is suffering.

Is the wound completely closed now? If not, did consultant check for infection with a swab test?

Even if the wound is closed, is it warm to the touch?

You need to make sure the wound is not still infected. Infection would explain the pain that your wife is suffering.

Re Contractubex - I doubt if it can be used on newborns. Hardly anything can. Babies' heads grow very fast and their cells are renewed at an incredible rate. I'm sure your baby's scar will disappear without a trace. At birth, two plates of DD's skull overlapped on the back. Perfectly fine now.

hi there

so sorry to have got you into trouble with the haircut...i just suggested it cos it made me feel better. perhaps you could suggest another pampering treatment with less chance of misinterpretation

i am doing reflexology and that makes me feel realy good. she comes to my house, and is a specialist in maternal medicine. also she does this thing called 'thought field therapy' (TFT) for pain management. i really think you should look it up. i felt better straight away after she did this and felt better for a few days. i'm now planning on doing it every 2 weeks until i'm better.

my son is now 12 weeks old. i saw the gynae dr yesterday, and he cut the granulation tissue under local anaesthetic and also did some more cauterisation of some internal granulation that we didn't even know was there cos we couldn' see it.

i do feel better and i felt better after he cauterised before, minus a blip in which the pain came back for a few days (which was what led me to get the earlier follow up appt).

im surprised the consultant wouldn't cauterise for another 6 weeks as that means not til youre 12 weeks, and i'm 12 weeks and i've had three treatments already.

one thing i would say is its really important to get a good consultant who is familiar with such cases. like i say, my consultant found granulation that we didn't even know was there and treated it- the GP on the other hand, bless her, was doing her best but she only did a 'surface area' treatment if you like cos she said herself shes never seen a case like mine. i dunno where you're based, but feel free to PM me (i think that's possible on mumsnet?) and i could recommend my consultant if we're in the same area.

re topical creams, ive used lidocaine and installagel, both available from pharmacies over the counter, they're mild local anaesthetics and totally safe for breast feeding (so safe that they were both used directly on my son when we had him circumcised). ask the pharmacist for advice on how to use when you get them. i didn't put it on the wound, but on the surrounding area which is where the pain is. these creams are not going to totally sort it out but they do provide some degree of pain relief.

one thing also is that your wife must make sure she doesn't get constipated at all. the gynae dr told me this, which was interesting cos i had already see a pattern for myself that the pain was worse the few hours before i emptied my bowels. and i have not really been constipated at all. so just having a full non-constipated bowel can add to the pain. the gynae dr said this was so important that i should even take BF-safe laxatives if i ever did get constipated.

your wife should also look for other patterns of pain as this will help her to manage the pain.

hope this helps. i'm feeling better today since the surgery yesterday and i just hope and pray it continues. [cote] is right, you can't underestimate how much pain your wife is in.