Continued support for SPHINCTER INJURIES, FISTULAE and other CHILDBIRTH INJURIES - the Ragged Bits Thread

[Jacksmama]

Hi all,
old thread here.

Cyee started this thread in May 2008 after her op, and it's been a haven of support for so many of us who have injuries to our bits from childbirth. Especially with respect to sphincter injuries, fistulae and incontinence after childbirth, there seems to be such a lack of support for women, and the entire subject seems to be taboo. It's as if most MD's think that "a certain amount of damage is to be expected after birth and you just have to live with it". Well, that is simply not the case - and this attitude is unacceptable.

There are all kinds of Ragged Bits stories on this thread. Be aware that THERE IS NO "TMI" HERE - this is the one place where you can spill it all. If you read through the old thread, which is nearly full, you'll see that someone, somewhere, has probably experienced it - whatever it is! So don't be embarrassed or ashamed... we'll tell our poo stories if you'll tell yours.

And also - there are success stories here. Several of us who have been through the medical mill have been successfully "repaired" and are "fully functional", so to speak or even expecting again. In those cases, please join us for Pervwatch - the "after action" report for anyone who is once again venturing into marital relations!

Welcome everyone. We're sorry you had to find us, but we're glad you're here.

Hi I have had no tests done just done my anal spincter has completly gone so I take it there is nothin else to do but try and sew it back will post later it is ds birthday today

(((HUGS))) Soapy :( - and happy birthday to your DS.

By the way - if any lurkers do name-change, remember to check which name you're posting under. I started a thread in the spring because I desperately needed help with an anal fissure . The thread was called "Hi, I'm oimyarsehurts and I have an anal fissure - HELP" - I really wanted it to be eye-catching. It obviously was as I got lots of help (best: dried apricots, from ThingOne) but I came back to it and posted as JM, completely outing myself. :o Oops! So let me have made that mistake for all of us, ok? :o

Hi I am new here. Was searching for info and found you guys.
I had my son 13 months ago and sustained a '2nd' degree tear and was stitched by a MW then home less than 12 hours later. After 2 days I did a poo and had a mass bleed, which I thought came from the anus, the MW came out and said she couldn't see where it was from and everything was fine. Over the next few weeks I was checked and told to be healing well, but it didn't feel right to me, very heavy and I was windy then 8 weeks later started to get anal urgency which got worse to mild incontinence, how embarrassing. I finally looked at myself and was horrified to find that I had no peranium, just one opening front to back. I went to the DR who referred me then that person referred me onward then after a few tests and scans was referred to a 3rd Doctor in another town. (I've really cut the story short) In march this year I had an op to repair all the damage (it certainly was not a 2nd degree tear but more like 4th!!!) I had surgery to repair my vaginal wall, anal shincter fold and a peranium built. By then my baby was 8 months old and it was the first time we were seperated, infact my other son, who is 6yrs, had never spent a night away from me either, and I ended up in hospital for 7 days. seeing my boys only twice, due to distance, was a killer. It took about 5 weeks before I felt anything near comfortable but suddenly after 8 weeks all pain, discomfort was just gone so I have spent the last few months relieved that I went through the surgery and living 'normally' again. That is until yesterday when I went for a poo and had blood :( Today I have had blood when I dab my back passage and OH has looked and said it is a very small fissure on the scar tissue :( I am very very worried now that things are going to go wrong, my op was 5 months ago, does anyone know if it is likely to open up again after this length of time? Has anyone had this op done and had bleeding suddenly a few months down the line?
Many thanks for reading

I've just been reading abit more from this thread and wanted to add that I too had my surgery done my Mr Kiff.

hello mummytoboys, I'm afraid I don't know if it's serious but I do know that I have had anal fissures of various ouchiness since my DS was born (also 13mo), they seem to come and go, heal then bleed and generally p* me off all the time. A great deal is related to how much fibre I eat. When I can stomach all bran every morning for a fortnight, they seem to improve, but a few 'lazy' eating weeks, and oh no - bloody poo (literally). I guess I would be most worried if it was a bleed of some volume, rather than just a bloody tissue IYSWIM? Bloody tissue I wouldn't panic over, just eat/drink more apricots and bran, and lots and lots of water. Blood in the water, and I would consult a GP asap.

Thanks for the advice KellyKettle - I've told my old line manager (just back from mat leave herself) about the appointment, but I don't want to tell my current manager (a bloke) at all. Will cross that bridge if/when I come to it... I'm taking it one day at a time right now. I'm still in pain every day - not agony, just general discomfort. More of a burning or hot pain 'inside' than heaviness or aching. I don't really know what that means, but I'm stupidly paranoid about the suggestion I have an unstitched hole near my cervix. I must take your advice about not speculating. Thanks to google you can give yourself a near hysterical panic when you think the worst!! Whichever way you look at it, I know I'm not right and I'm fed up of not knowing. Roll on finding out the gory details next week.

Have any of you had a birth afterthoughts service come explain your notes to you? I did when DS was 6mo, but I am contemplating getting them to come again, if they will. Last time the midwife held my notes and I never saw them. She explained some things to me but I actually want my own copy now, and time to read them. My recollection is that I refused consent, repeatedly, for a forceps delivery. They argued with me for something between 45mins and an hour and a half until I screamed in agony to get the baby out of me - then they did an emergency forceps delivery in theatre, which I was utterly distraught about. I had severe, disabling SPD which was reason enough to refuse... but if they have caused me a) to need 7mo of physiotherapy to walk again painfree, and b) to need secondary surgery to correct the mess they made of my fanjo... well. I think it's about time I put in a complaint. Has anyone else complained about their birth experience? Is it worth pursuing? Or am I being dramatic? I just don't understand how 'informed consent' can be informed, if you are not allowed to refuse consent when you know the risks involved? That's messed up, right?

Sorry for thread rant!! I'll go have a and get off my soap box now...

which reminds me, soapy, hug

Mummy Mr Kiff is great isn't he? He has said to me if I want to see him call his secretary. He even replies to email enquiries (although perhaps not at MN posting speed). I'd call his secretary if I were you and ask to see him or his registrar.

I'm so sorry you had such a shocking experience but I'm pleased that the repair was positive overall. I don't know much about fissures but if you're worried, don't delay, get in touch with the hospital for reassurance.

Posting from my phone so I need to post this, reread & post again sorry.

BTW - laughed my socks off at JM outing herself

I would have thought 5 months was plenty of time for the repair to heal. Were you, erm, straining?

sillyworried when I had my endo-anal scan the sonographer/consultant looked so said and told me that I had a defect in my internal sphincter (massive under statement) and he was very sorry to tell me that it was really difficult to repair but my surgeon would explain more at my appointment. Cue weeks of googling, sobbing about painful op, colostomy bag whilst recovering etc. I saw my consultant (not Kiff) and he said they couldn't actually repair it at all. Cue sobbing about remaining unfixed!

I had a birth debrief with a consultant. It helped a lot actually. I followed it up with a complaint letter which was pretty much finned off with 2 crap replies. That left me heart broken but they obviously didn't want to admit to much on paper.

I too had issues with consent and they agreed that it hadn't been done properly. J hadn't been told an episiotomy would be performed or that there was a risk or tearing leading to incontinence. They said it didn't matter by then, forceps were the only option anyway as baby was too low for a cs. They used high forceps though so I don't know. I'm not medically qualified so I assume they're right.

I paid £50 for my notes - very upsetting to read but worth every penny.

I was rushing yesterday which is what I thought it could of been but today I've been very relaxed, I guess if I caused damadge yesterday then it would still be evident today :(

Mr Kiff said I could call him if ever I had any questions. was worried about anything etc. Will try and dig out one of the letters tomorrow, I have put them all 'somewhere safe'

Sillyworriedmama, I put in a complain. I got a response, it wasn't great but at least I voiced my concerns. My consultant (kiff) told me to right down everything in it, how I was feeling, what I think should change for future patients, absolutely everything. He said I probably wouldn't get a reply ,but I did, but that it would be filed with others and 'eventually' they mount up and action is taken. He was writting a letter on my behalf too.

I am so glad that I found this thread :)

Ps (last post before I pass out exhausted!),

I told a female line manager but changed jobs & got a male LM. My company gas a policy of allowing you privacy about speaking to someone else about illness & they just inform your LM that you'll be off & they know why, have checked it's compliant etc. I never had to discuss it with my male boss (although he was so great through my MMC that he probably would have been fine).

I'm glad I could give you a giggle KK :o

I have actually found something better than dried apricots for soft stools - magnesium. Preferably magnesium glycinate in capsule form. I won't apologize for TMI because there can be none on this thread (so bring it on!!) but I have never had such comfortable poos in my life. :o

Welcome to any newcomers BTW.

Oh, and I say yes yes to getting an actual copy of birth notes, as well as putting in a detailed complaint. Birth notes can be really upsetting to read, however :( - so I'd say have someone with you whose shoulder you can cry on. If you can. I don't know who I'd have asked. :( Not that I don't have any friends (!!) or a lovely DH but you really want someone special.

In a perfect world, we could all get our birth notes, have an international meet-up, get piss-drunk and help each other read our notes.

Hi I was wondering what the op was like?? I was left with a opened 3rd degree tear tear and a unnoticed 4th degree one and that was something else I could never experience pain like that again?? or could I?? I thought I was going to die and never waken up wen I eventually went to sleep.

Anyone else tryed tapendadol?? im waitin on it coming into stock at chemist. 3 weeks left to see my surgeon im terrified as I have already said.

Anyone else reading this thread and needing a colostomy-4th-degree-tear thanx for birthday wish Jacks as for ds he had a good and im suffering for it today but I had to make an effort.

Soapy sorry I meant to post more to you.

Can you remind me about your tear? Did they repair none of it or some of it? Was it misclassified as a 3rd but it's a 4th?

My ops have all been painful to some degree but like JM says the pain was nowhere near as bad as the pain from the original injuries & psychologically it was good for me because I felt "fixed".

I can't remember what pain relief I used. I do remember the pain impacting my personal and professional life.

at international birth notes top trumps!!

Hi kellykettle yes an undetected 4th and stitching came from episiomity which caused a 3rd also undected so it is 2 seperate tears what a mess

Does this sound right
vacum applied after 3 goes nothing happen
one pull of forceps done some progress
episiomity done with 2nd forceps pull baby delivered

im only guessing should the episiomy not of been performed at the 1st forceps pull as vacum was not blushing well as they put it?? then the injury would not of occured or would 3 pulls of vacum of helped to cause the damage? could this injury been prevented?? thanks

I doubt it Soapy, 4th degree tears are much more likely to be an extension of an episiotomy. Your body generally would tear as far as needed to let the baby out (natural tear) but if you are cut it is much easier for that to tear further (a good analogy is trying to rip a yellow pages with your bear hands - impossible. Put a big cut in it and now try to rip it - easy).

By the time the baby is that low down but stuck there isn't much else they can do besides ventouse and then forceps. If they both fail it's an emergency CS but it's much riskier because they're pulling the baby back up out of the pelvis.

You sound so angry and I completely understand why. I think you need to go through your notes page by page with a obstetrician from the hospital. They need to help you to understand what happened. Try calling PALS about it, they are very helpful and on the side of the patient.

You also need to go back to your GP (are you in the UK?) and insist on counselling. I can't believe they've refused it.

I also highly recommend a book called Birth Crisis by Sheila Kitzinger. It helped me a lot in understanding and dealing with my feelings after the birth.

Ps I think it sounds like you have one tear - 4th degree. They repaired what they believed to be a 3rd but in fact it is a 4th degree.

If your repair to your vagina hasn't worked and now they've found a tear into your sphincters then that should make a full repair easier

Soapy, how have they diagnosed the 4th degree tear without conducting any tests? It may not be as bad as a 4th if they haven't got "proof".

Thanks kellykettle I was told I had a episiomity nothin more so I took from that a slight cut?? im confused so all along you reckon I had a 3rd degree tear there are nothin on my notes or doctors notes saying this??? should it not of be written in my notes?? im confused but you are helping me to understand thank you I was told I would be better in one week??confused there is no evidence of this which leads to not understanging

consultant stuck her finger up my bum and said my anal spincter is completely gone and she has never dealt with this before

sori to rant ladies im trying to understand this

Episiotomy is the equivalent of a second degree tear (through vagina), 3rd is vagina and part of external anal sphincter, 4th is vagina and sphincters.

I don't think a 4th can be diagnosed so simply. It sounds like a squeeze test which is just a basic test for assessing muscle strength in your sphincters.

I think it's more likely that your surgeon will refer you for more tests first although I'd have thought they'd have done that before deciding whether or not to refer you to a surgeon. Or you're just delayed further waiting for tests after seeing them.

How is your continence now? Control of wind?

Ps anecdotally speaking I think an episiotomy takes longer than a week or so to heal. Leaving the hospital uninformed about your injuries isn't uncommon unfortunately

No I'm not saying you have a 3rd, I thought you said you had a 3rd which didn't repair properly and a missed 4th.

I couldn't diagnose you even if you even if you let me have a look

I have no control of anything im in agony even to empty my bladder wen I need to go I just go I know en I need to go but stool just falls out thanks kellykettle

oh kellykettle forgot to add consultant said I had a episomity breakdown and a 3rd degree tear was missed
my 4th tear probably went unnoticed at the delivery

im sori im doin ur head in and i know you do not have the answers I won't hound to again