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.

Oh dear ((((((HUG)))))) :(

l4k - good god - big hugs to you... Hope you start to feel stronger soon...

l4k - how are you doing?

Hi
Have just got back from hospital again. Have had a swollen painfull belly since last night and had a temp of 38.2 in the night too.
Saw consultant in private wing of local hospital ( op was done in london on nhs) who said all seems well. They will contact me for another scan this week to check on hematoma but he examined me and said all as he expected. Only wierd thing is my abdomen is so tender at top, right and centre under ribs. Hope it's not gallbladder probs on top of everything
Anyway, thanks for asking. X

Golly 14k you are certainly going through it . I do hope you feel much better soon . Rest as much as you can . Contact the hospital again if you are worried but hopefully they have put your mind at rest
.keep posting to let us know how you are

Been lurking on this thread for a whole. But haven't contributed as I know I've got off so much lighter than most others here.

But the issue has come to the forefront of my mind as I'm now 20w with baby #2, and I have an appointment with an Obstetric Consultant on the 22nd December.

I suffered a 3rd Degree tear with my daughter in 2009. No obvious reason, other than I was on my back and in stirrups. No intervention. It was all fairly straightforward, tear noted and dealt with straight away in theatre.

But I found the whole experience of childbirth utterly horrendous and degrading, despite on paper it being perfectly fine. I went through the last 3hrs with pretty much no pain relief as I wasn't in enough control to get the benefits of the Gas & Air, and it was "too late" for any other pain relief. I just remember wanting to die. I don't really remember DD being born.

The tear took about 12 weeks to heal, and I'm left with a lot of faecal urgency, a small about of urine leakage, and pretty much zero control over gas.

I'm terrified of going through another labour and birth, terrified of tearing again, terrified of my symptoms getting worse.

But above all else, I'm terrified of my request for an ELCS to be turned down. ATEOTD it was "only" a 3a, I was able to birth on my own, and my symptoms are relatively minor. I'm so scared that they are going to turn around and say that because I'm unlikely to tear to the same extent again, and that it was a "successful" natural birth that there is no need for a section.

Does anyone else have experience with subsequent births/requests for an ELCS?

Sorry cosmic mouse I can't help you with elec c but there are sure to be others on here who can. Good luck

14k, how are you?

Cosmicmouse, I think if I were you, I'd state with some repetition that you have been traumatized by what happened, that you have residual problems as you detailed above and that you simply don't feel capable of going through another vaginal birth and potentially worsening the problems you have. And that you'd like an ELCS. And stick to that.
You may have to get to be very good at holding up your hand to interrupt anyone who tries to argue with you and persuade you otherwise and calmly say "I'm not going to argue about this. I want an ELCS. You're not hearing me. I want an ELCS." Repeat as necessary.

Is your DH on board with this? It would help if he could come with you to your appointments and say things like "my wife wants an ELCS. How do we make that happen? Are you not hearing us? We'd like a CS. How do we make that happen?" And refuse to take no for an answer.

hi cosmicmouse. I also had 3rd/4th degree tear which was never detected despite months of pain postnatally after undiagnosed breech (home birth with hospital transfer at stage 2). Have been left with faecal incontinence and urgency, a rectovaginal fistula, and terrible wind issues. About to embark on surgery in New Year to rebuild everything including having to have an ileostomy. Then starting on psychological repair! I had an elcs for my 2nd DD. Have any of your symptoms been discussed with your doc or a consultant? I was immediately referred for ELCS and didn' really get a choice. I would keep demanding one and ask for gps reference if you get probs. Good luck!

Thanks to those who've replied.

Jacksmania - I think you may be right about taking the decisive line. Going in asking what they recommend may not necessarily be appropriate on this situation I suppose. I've made my peace with my need for a section, I'm really not capable of entering into a debate on it now.

Fitterfly - I haven't seen anyone about my symptoms no, mainly as they are bearable and not causing me too many issues aside from the embarrassment of not being able to control my gas. Do you think it would be worth visiting my GP prior to my consultant appointment? Would he do me a letter do you think? And in time? As consultant is on the 22nd?

Cosmic, even if your GP can't get a letter done for you in time for the 22nd, it might be a good idea to discuss your symptoms just do you have them documented.

FWIW, I had severe problems controlling wind after I had DS (Feb 2008), and have only found in the last year or so that I can keep it in better. I was told that any deficits I still had two years post-birth would likely stay with me but I haven't found that to be true. I've definitely noticed improvement in the last two years (DS will be four in Feb) but, I've also not had a subsequent pregnancy to stress my body. What I'm trying to say is, I hope you can get a CS, and recover emotionally as well, and have some hope that your symptoms will get better over time.
Please keep posting. We're good at handholding on this thread.

Flitterfly, when is your op scheduled? Best, best, best of luck.

Just starting to feel a bit better now,but still can't make it through the day without sleeping.Pain is lots better apart from when needing a bowel movement,that still hurts! Its been 3 weeks today,I just hope I have no need to go into hospital over christmas.Still waiting for a scan time this week to check hematoma.

Cosmic mouse-if you want an elcs,you can get one.I changed consultant mid way through dc3 pregnancy to get it.Tell them all your fears and don't hold back.Get your dh to back you up.
it is so much less stressful
They will tell you that the carrying of the baby can do damage too,this is unfortunately true in my experience but its nothing compared to the damage some of us have suffered in vaginal childbirth.
good luck for your appointment.

(((((14k))))))

ARGH - just lost my message!

In brief:

• hugs to you l4k. hope you start feeling your recovery is taking hold.
• welcome cosmicmouse. agree with everyone else that you need to be demanding and not allow our ingrained 'doc knows best' behaviour to take over. Also agree you should see your doc, partly to support ELCS conversations, but also because you could access specialist physio (either now or post baby) that could really help with some of the symptoms you're having. I thought it was brilliant, despite having aprpoached it with a fairly cynical perspective (e.g. I don't need to be told how to clench!).

Take care all... fingers crossed I don't lose this one!

hi, just found this thread - it's great!
Nothing compared to some of you, but I had a 4th degree tear in 2007 with DD1, then another VB with DD2 in 2009 as I had no symptoms. The birth went fine as they gave me an epiosiotomy to direct tear away from anus and I healed really quickly.
Trouble is, I have been having some problems with gas for a while now, and I am scared they are going to get worse. I cannot hold a fart in, which is soo embarrassing sometimes. I try and do pelvic floor, but tbh I find it really difficult to feel that I am doing them right. I think my muscle must be pretty weak. Should I see my gp (quite embarrassed about this)? Is there even anything they can do? We are trying for dc3, but I am scared I am going to make my symptoms, which are manageable at the moment, worse. I am only 30, and although my symptoms aren't that bad now, I worry what I'm going to be like when I'm 50.

Hi oldgran - like I told Cosmicmouse, I found it quite hard to hold in wind for about two-three years after DS's birth and then found it got better. So it may improve by itself. But if you're going for DC3 then yes, I think mention it to your GP, or even just non-specifically ask if you could be referred to a pelvic floor physio. If your GP asks why you'll could just say you feel your pelvic floor is quite weak and would like some help, and if s/he insists on knowing the exact nature of the issue, well, you'll have to bite the bullet and say why .
Good luck . Glad you found us.

Thanks Jacksmania.
I never had any physio afterwards by the way - didn't even think to ask. Very little follow-up actually.
I may ask my GP re. physio. HAs anyone heard of the pelvic toner you can get on prescription?

I don't know if it's the same as this but I got a Pelvic Floor Educator from my physio. Here. No prescription needed I think?

Hi oldgran. You should most definitely see a specialist gynae physio for a pelvic floor assessment and for treatment. With injuries such as these, doing pelvic floor exercises on your own might not be enough and you might need some extra help to kick start things and get them stronger. In my case I had a VB in 2010 and sustained a csytocele, rectocele, uterine prolapse and detached puborectalis muscle (bit at the rear under the perineum). Trying to do pelvic floors on my own was useless - i thought I was doing it, but I wasn't. So my gynae told me to use a NeuroTrac Continence pelvic floor stimulator www.win-health.com/neurotrac_continence.html. This has made a big difference - I have gone from 0 out of 5 to 2-3 out of 5. For God's sake don't use this without supervision - there's a real risk of injuring yourself if you use the wrong programme or put it on too high a strength. If you are in/near London I can recommend my physio, she is amazing. X

Hello all
Just to update. Been to see cons and have a scan. The good news is the hematoma is shrinking , down to 3.5 cm from 5.5 cm
The bad news is they found I have a large cyst on an ovary, over two inches he said. Will now have follow up scan for that in feb
Also. Without me mentioning it he said he thinks I need upper GI investigations to look at gallbladder etc. I said I'm ignoring it but he has advised me not to.
It's always something with me! But I am feeling a tiny bit better daily.
So what's with the cyst ? Any ideas? X

Oh dear 14K, just no end in sight for you, is there? :(
The cyst could be a follicular cyst. As far as I can remember, they can grow and shrink, and grow and shrink again. Or it could be what's euphemistically called a "chocolate cyst" - it's filled with blood, eeewww, and they don't tend to shrink. Does it hurt?
And yuck re gallbladder investigation.
But I'm super-happy that your haematoma is shrinking. At least, a little bit of good news! :)

Hi Cosmicmouse. Yes I would definitely see your doc to get the symptoms down on record and keep up the pressure for a ELCS. Afterall, it is all over the press at the moment that women who don't even really need one have the right to request a section - so stay firm. You have a valid reason.

Jacksmania - waiting for the date to come through from the consultant. need it to hurry up as have a fair bit of organising to sort out before it happens.

And to all who have had 'wind' issues. Don't let docs fob you off with 'oh things stretch' answers. Great if it clears on its own but from 1st hand experience I have been told that no amount of pelvic floor training (and I had lots of physio from a great team) would fix the damage from the tears. I know how much of a nightmare it is to live with and for me it has had big psychological effects. Keep going back to the docs and make sure you write down the sequence and regularity of symptoms. It has taken 3 years but finally the penny dropped with the medical team that 'something isn't right'!

Good luck flitterfly, let us know when your date is so we can cross all available appendages for you :)

Thanks everyone for the support before Christmas re: my upcoming consultants appointment. I had to cancel my original appointment due to a lovely D&V bug hitting me the day before...but I had my rescheduled appointment today, and it was very positive.

I had in my notes that I was there to discuss "Mode of Delivery" so he read through my notes and started to go on about the fact that with a 3A tear, he would recommend a normal birth. But as soon as I mentioned my continence issues, he changed his tune and said that in that case he understood my concerns and agreed that it would probably be best to go for a C-Section!

I didn't need to go into any of the psychological reasons why I feel a Section is best (i.e trauma surrounding DD's birth, flashbacks etc). Which was a relief as I was a bit worried as to whether I'd be able to explain all that without sounding like a nutter.

So I've been able to breathe a massive sigh of relief. It's all in my notes to say he's agreed a C-Section, and I've made an appointment to go back at 35+5 to get a date although he said it's likely to be either 20th, 23rd or 24th April.

Hopefully I can relax into this pregnancy a bit more now, and focus on having a peaceful birth and post-natal period, and a successful breastfeeding relationship this time around.

Oh fantastic CosmicMouse!!!!!!
I am so ridiculously pleased for you, I nearly woke up DS (sleeping peacefully across my lap) yelping "yessssss!" :o

Just wondering, do you think it might be beneficial for you to ask for some counselling re: the flashbacks? I'd just be worried that as the baby's birth comes closer, even though you're having a section, that your brain might go into a bit of panic mode? I've tended to have more flashbacks around DS's birthdays, oddly, even though for me a second baby was impossible. Brains are odd that way. I'd just really want you to feel as safe and relaxed and happy as possible. And I was just thinking, even though I know free time is at a premium with a toddler, you'll probably have more time before baby #2 arrives than after. Just a thought. If not practical, ignore.