GussieGrips I need you!

[bananarama3]

NC to the username-for-embarrassing problems...

So back story: I have 3 children, all vaginal births. Two 2nd degree tears, one stitched, one left to heal by itself. I have ALWAYS done pfe since being an impressionable young lady and having (due to utterly professional reasons) seen an elderly lady with a ginormous uterine prolapse.

Fast forward to a year or two ago, I started leaking. Not loads, but a bit whilst dancing/jumping stuff like that. I did MORE pfe. They did nowt. I bought aqua flex cones. Couldn't get past about 35g in the big cone and even then sometimes that just fell out.

I happened to have my legs in stirrups and a consultant gynaecologist between my knees a few weeks ago and I thought I'd ask her opinion. She had a fish around (once she'd fetched all the various instruments that were in me, out...) and said yes I had some damage but I'd had three kids - this delivered with a sort of professional shrug. She told me to do pfe. I told her I already was. She told me to cross my legs and squeeze my bum cheeks together while I did them. She's a consultant. I tried that, did nowt.

So I did some research and bought a kegel8 machine and it's working wonders for the leaking. Nothing since I started using it a fortnight ago. Brilliant. However I got the copy of the letter from the consultant to my gp and in it she says that I have a first degree descent of my uterus. This is a prolapse yes? She also says I have a cystocele and a uterocele (seen on USS prior to my seeing gynae) She did not tell me any of this. I'm alternating between devastated, terrified and furious. Am I just supposed to wait until my uterus and various other organs are sitting in my knickers before they'll suggest something other than pfe that clearly were not up to the job? Should I be running? I've been to a kids party this afternoon. I danced and jumped around. Is this advisable?? I'm asking you for help and I think you'll say I need to get referred to a women's health physio but I'm just so livid that this hasn't been suggested from the people who bloody spotted the problem.

Help.

she's on twitter!

Okay- I've had some of this. I had a repair at 36 for a slight uterine descent and a bladder prolapse. They weren't terrible , but I felt bulgy. PFE don't work for it all- slack tissue is slack tissue and the only solution sometimes is to cut out the slack and stitch it all back in. See another gynae- I saw 3 drs before the 3rd agreed there was a problem.

You ought not to run- will make it a million times worse. I started running a few years after my op and felt it all getting worse, saw a physio who said NO RUNNING, NO HIGH IMPACT EXERCISES EVER. This is also includes some kinds of Pilates, yoga and gym work where strain goes to the pelvic floor.

A grade 1 prolapse is not severe- your uterus ought still to be quite high up. You might stop it getting worse with the pfe, but you also ought to ask for another opinion and if a repair is possible.

Thanks perky - I'm not on twitter, am I going to have to develop my technology skills to get to her?!

Useful information you've given me, thank you. I don't think I can bear the thought of no running, no dancing, no exercise classes though... I need to speak to a person about all of this. Like I said, the dribbly problem seems to have been stopped by the kegel8, I'm being very diligent and using it twice a day. I don't have any of the bulgy feelings you described - this must be a good thing?

Look- being blunt- if you have existing prolapses, you can't run except if you are happy to make them worse. End of.

Gussie doesn't answer individual questions- she's a trained women's physio and a comedian, but she's not there for us to ask her questions at random! She has a youtube video about exercises if you can find that.

You can do some exercise. The rule is nothing high impact and that means both feet off the floor at the same time. It also means no exercises that increase abdominal pressure, and no heavy lifting.

Suggest you look at the fab website of Michelle Kenway- she's an Oz women's physio with her work dedicated to pelvic floors. Lots of exercises on the site and tips- and she will answer questions if you email her.

Also worth looking at the app pelvic floor first which has excercises which are safe.

There is a product that can support the pelvic floor when exercising. I've forgotten the name though. Maybe have a Google. I use the aquaflex too though it does say not to use it with a prolapse as it could make it worse.

Also I imagine most women after 3 children would have a slightly lower cervix. I doubt it means you are destined to be like that poor old lady you encountered.

Stairway I wouldn't have bought/used the aqua flex if I'd known about the prolapses. Hopefully because they didn't work and I gave up, it won't have done any damage! Re the lower cervix I agree, but a prolapsed bladder too?? I'm keeping up with the kegel8 twice a day and so far it's had a fantastic effect on my stress incontinence. I've not been troubled with that since I started using it. Does anyone know if you can reverse a prolapse without surgery?

I'll have a google around for the safe exercises and support thing. Thanks for advice

There are no cut and dried answers to this (ha- like the pun ? :))
The upshot is that women with small prolapses might find them bothersome and some might not. Surgery is the route if you find your symptoms bother you. Some women have prolapses but no leaking. Some small prolapses can be 'cured' or at least made no worse by pfe. But on the other hand, if something has been really stretched, it might need a nip and tuck to sort it out. it's very common and it's not a huge operation though you can't lift or do anything strenuous for 6 weeks. I was advised never to lift over 14lbs (max) for life and tbh I don't lift more than a 6lb bag of spuds.

Have a really good read of the site for Michelle Kenway- many of the points you raise are answered there.

May I hijack your thread, OP.

GP did an internal the other day (bladder problem), informed me I had a small prolapse and to do pfe. I've never given birth (DS is adopted) so assume prolapse is age related (had earlyish menopause).

Can I just spend £140 quid on a Kegel or do I actually have to do proper exercise?

My understanding is that machines don't give any better results but google machines v pfe and see what's been researched. Certainly, cones are no better than doing exercises.

Daisy - as far as I know pfe are the way to go IF you can do them effectively. My suspicion after two weeks of using the machine, is that I had muscle/nerve damage from childbirth that meant my efforts at pfe were ineffective. I'm finding my solo efforts since using the kegel8 seem to be stronger. That might just be my perception though. I've definitely noticed an improvement with leaking though ie none since starting which is brilliant.

If you can do the exercises, and save the money, personally I'd do that - again as far as I know there is good evidence that pfe are effective and they're free!

Oh and Polly, that's interesting re the cones because despite diligence, I just couldn't get them to work for me!

Ask for a referral to a uro-gynae clinic and/or a specialist Women's Health phsyio (one like gussie )
Have urodynamic studies done.

Cystocele really just means that the front wall (towards your bladder) of your vagina is a little weakened, rectocele ditto for the back wall (towards your bowel). 1st degree uterine descent is just what it sound like - a prolapse is more like what you describe in your OP
Yes, they are all a sign of weakened pelvic floor structures including core muscles of your abdomen and back.

I have benefitted hugely from a physios advice - it has changed how I do my PFE. Btw, the one I saw was quite dismissive of weights and gadgets

Wrt running etc - I have decided to avoid high impact exercise, but you can get PFsupport devices that some female runners use. The argument is that for anything you'd wear a sport bra for, you should also support your PF

Oh, and physio also suggested that the most effective way to do PFE was standing on your head - gravity taking all load off the PF thereby allowing for very effective contractions.
As this is probably not the position of choice for most people, she suggested doing them first thing in the morning, lying down in bed before getting up. It has made a difference to me….

That's interesting 'Pacific* because your last point is the complete opposite of what Michelle Kenway (women's physio) says!

In some of the Q&As on her website, someone said they could only do PFE lying down. Her reply is that you can start doing them lying down but the support you will get that way will only 'work' in lying-down positions. She says if you want to increase support when standing up, then you have to do the exercises standing up. Doing them standing up is working against gravity so it stands to reason that it's harder at first. I could only do 2-3 properly standing up but now I can do 8-10. It makes sense to me to do them standing up because that's when most strain goes on the PF day to day .

Oh, yes, standing up is harder; doing them standing up with your legs apart even harder, so it's all a progression.
But to build up strength my understanding was you have to start with little 'load' on the hammock of muscles to get them to tone up and then increase how much you ask of them.

I am no expert, but it did make sense to me.

You shouldn't do them with your legs apart. This puts too much strain on the pelvic floor.
Michelle suggests working up from lying down, to sitting, ( she suggests on an exercise ball to help core stability) then standing.

Holistic Core and Restore

http://holisticcorerestore.com/

Made a huge difference to me within just a few sessions, worth a look.

To go against the grain, I had similar to you after 2 vaginal births op and when my youngest was 1, I started HIIT exercise and actually, I found I was working so hard at 'holding everything up' that those muscles got a great workout and within a few weeks, the problem had resolved.

I had been told surgery was the only proper fix, but for me, exercising and being conscious of tightening that area while doing it was the fix.

I'm not saying go and spend an hour a day on a trampoline because I don't know your exact condition, but for me, HIIT exercise with lots of jumping cured my problem.

Legs apart PFE may be done by people with a v strong PF who wish to put more strong on their undercarriage i.e. weight lifters etc.

It is all a progression, isn't it, from lying down, to sitting to standing and, for those who want to go beyond 'normal' strain on their PF, legs apart. I am not proposing it for every day/run of the mill PF health and fitness. But the mechanics of it all (including the whole core) make sense to me.