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WE ARE ALL 3RD DEGREE - or probably will be
Hi Everyone,
I found a 2005 editorial from the International Urogynecology Journal titled, “Pelvic organ prolapse: is it time to define it?” that indeed seems timely.
The article begins by the author telling us:
“For most practitioners, pelvic organ prolapse is something which they recognize when they see it and conversely recognize its absence, but they cannot define the point when a patient goes from normal support to pelvic organ prolapse. Despite this, researchers in the field of urogynecology continue to report on surgical cure rates and epidemiologic risk factors for pelvic organ prolapse despite having no clear cut uniformly recognized definition for the disease. Could you imagine the state of affairs in cardiovascular research if hypertension was a vaguely defined entity whose definition was left up to the individual investigator?”
He goes on to say current research has revealed that up to 11% of women from various populations have prolapse “at or beyond” the “hymenal remnants”. Having never located my hymenal remnants, I can only guess this to be the vaginal opening – which translates as stage III in the POPQ system. In addition, several of these studies show a bell-shaped distribution with 80-90% of ALL women having stage I or II prolapse. However, the author concludes by stating no, it is not quite time to define prolapse.
These findings will come as no surprise to wholewomen who have known for years that prolapse is extremely common. It must be quite vexing for surgeons who are being pressured by large political bodies like the National Institutes of Health to create an anatomical definition of prolapse – only to have that definition imply normalcy, not disease.
What I find interesting is that although stage IV prolapse is included in the POPQ diagnostic system, it is rarely mentioned in real life or scientific study. Using my own body as template for understanding this, I have long surmised that most uterosacral ligaments and most lumbosacral curves do not allow the uterus or bladder to descend much past the vaginal opening. This would exclude the elderly woman confined to a hospital bed for years on end who has lost her POSS (pelvic organ support system). As a matter of fact, the very thing that will exacerbate my symptoms is lying in bed with my torso propped up on pillows (although I do love those precious hours!)
We know that more commonly than not, prolapse continues on a “course” that finally stabilizes at or near the introitus. This is true of women of all ages and just seems to be the way the mature pelvis settles out. When it happens suddenly in the postpartum mother it is usually devastating. The funneling of the organs toward the back of the pelvis creates tugging on spinal nerves and results in tremendous pressure in the “butt.” THIS IS THE PRIMARY SYMPTOM WOMEN REPORT IMPROVEMENT IN ONCE THEY ARE ESTABLISHED IN THE POSTURAL WORK.
Prolapse never really goes away, but symptoms improve immeasurably when we reestablish the natural shape of the female spine, from which the pelvic organs are suspended. This is what urogynecologists will never tell us because first, they don’t know, and secondly, well…you know…
- Christine's blog
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Thanks :-)
I think at this point in my life it is about a 'mindset'
That took alot to get into the mind...
But - As we hafta live - LIVE I shall...
I don't exercise as much as I did. I will prolly get back to that. But have done alot more than I used to - And having more fun :-)
Sometimes you are holding someone else's heart whithin your hands. You can drop that heart & bruise it. You can squash that heart & hurt it. Or you can stomp on it & totally annihalate it. You stomp on that heart or bruise it. It can forever be changed.
Gooooooo Sue !!!!!
Good for you! Great news! I'm so happy for you...happy to read the joy in your words...happy to see the sparkle in you eyes (even though I'm imagining it I know it was there). You deserved it, and you made my day a happier one by sharing your day with us.
{{BIG smile}}
Goldfinch
'Life is not holding a good hand; Life is playing a poor hand well'
Score = Me = 1 - POP = 0 - LIVING.....
I had the most fantastic day - Living well - YESSSSSSSSS
We have two classic cars - So we took one of them on a 'run' - Met up with members of our club and about 20 or 30 of us went in convoy to some place I cant remember the name of. All last minute but I threw a picnic together...
A convoy of head turning cars (Ours being unclean as it was last minute)
Got there where Daughter played with other kids - *He* played rounders (LOLOL) with the adults.
Me - All held up and happy with sponge giving support so nothing to worry about on that score...
In fact - If I didn't know it - Nobody else would know I have 'this POPping problem' at all...
It was a long day. I was worried about the sponge being in so long... But to be honest I had the most FUN day I have had all year...
Just writing this cos with the help of these sponges I feel this POP has not gotten the better of me. And I CAN do things I never thought I would be able to when it decided to be a pain... But - Maybe life has taken a curve... But... Life is still life...
I still have a 3rd degree POP - But...... At this point in life - I am winning the game... With the help of my friend - Spongerama
:-)
The sun was out here for a change - It was a beautiful day... I only wish I hadn't left my camera on the table by the front door :-(
And..... I wore my W.W. T shirt also. It matched my trousers (Green) And looked all nice and summery..... And... Makes me feel good. Dunno why - Maybe it is like a secret thing - The Logo being something someone else would be informed of if they asked me what it meant...
Hope everyone had a great day today too...
Sometimes you are holding someone else's heart whithin your hands. You can drop that heart & bruise it. You can squash that heart & hurt it. Or you can stomp on it & totally annihalate it. You stomp on that heart or bruise it. It can forever be changed.
Rethinking seating
Hi Tiddbits
I didn't want to cram too much info into my first comment, but since you are now asking ...
I meant that when we sit it needs to be easy to stay in posture, and so often we do not choose where we sit. We can stand, walk and run in WW posture anywhere, but we need strategies for 'sitting well', no matter we are told to sit, or whatever seating is available, and to use good seating wherever we can.
My strategies are these.
I have a theory that seats do not support the body in any way other than allowing us to be off the floor. Christine would take it a step further and suggest that we sit on the floor, not on chairs. Yes, I often sit on the ground/floor as well. Cross-legged and weight well forward allows us to keep the lumbar curve, and stretch the gluteal muscles, or legs straight in front which also allows the hamstrings to relax. I don't find there is any need for back support whatever, not even to maintain support for the lower back. IMHO chair backs are decorative only. That's what we have muscles for, and by habitually giving our spine something to lean on, it is not practising supporting itself. Hence, sitting anywhere in posture is easy for me. If I have to sit in a slouchy chair I just sit on the edge with my feet firmly planted on the floor, and probably my feet well apart to allow my belly to expand.
The sitting posture principles are, for me:-
x Feet apart and firmly planted (wear longer skirts or trousers)
x Thighs sloping down forwards a little, or if the seat is very low and the thighs have to slope upwards then keep the feet well apart, semi-squatting on the edge, so you can
x Sit on the pubic bone more than the sit bones. This
x Keeps the lumbar curve in place
x Belly relaxed so the organs are well forward.
From the waist up, normal WW rules apply.
For my personal seats my computer chair has had the back taken off and a wide horizontal piece of ply bolted to the pedestal. It still has adjustable height and castors. I could sit on it cross-legged but haven't yet found a suitable cushion to stop my feet from going to sleep. Currently I am using one of those slightly inflated balance disks you get from a physical therapist. They are usually used for standing on for re-establishing balance after an ankle injury and things like that. It is a great cushion for my office stool, with just enough air to be flat lunderneath with a tiny bit of padding and slightly inflated bit out the back to support the back part of my buttocks which are otherwise up in the air a bit when I sit properly.
The driver's seat in my car is adjusted to be as high as possible with a foam wedge under the carseat cover to make it more horizontal. I also have a lumbar support cushion hanging from the top, which I use more as a means of creating space underneath the cushion for my butt. However, it is quite hard to sit upright when driving a car, so the lumbar cushion does help keep my lumbar curve in place and keeps my centre of gravity forward. In other cars the lumbar cushion is vital, as there are few passenger car seats that are built for sitting upright. You need to compromise sometimes, but the less the better.
These are a few ideas, based on training the body to support itself, and keeping the organs forward at all times. I can sit like this all day now. After sitting and standing with tummy in and butt tucked under for the previous 45 years it takes quite a lot of training to reeducate the brain to do it differently, but I am getting there. It really is a 24/7 thing when you are upright.
BTW, there are times when I slouch on the sofa, but it doesn't matter as I do it well the rest of the time.
Cheers
Louise
Learning and Living
Thanks so much for your detailed comments. I went back and read the entry on the pudendal nerve entrapment. When I birthed my youngest daughter (supposedly natural childbirth, breech baby, butt first) at the hospital, the doc gave me a "hole to hole" episiotomy (without consent, of course). It took a long time to heal up well. The scar is there and obviously quite deep. I have always wondered if that is the root of this low rectocele issue I have now.
I guess I get pretty discouraged when I have flare-ups. I always have lived a very active, sports-oriented life style. Now I feel like a wimp, quite hesitant to get involved.
I have the first edition of Christine's book. I am back in South America and will not be able to get any updates until our next trip to the States. I have tried to sort out the correct posture thing, but I guess I must be dense because it seems awkward and uncomfortable. I would also like to know what you meant about "rethinking seating" that you mentioned. About three weeks ago I began to have to be in front of the computer much more (end of the school year), and longer periods sitting combined with a problem pooping one day seem to have been the triggers that caused this flare up. I do eat carefully and correctly as much as possible. Something just happened that day. Also, is there a correct way for sleeping?
Another question I have is how can we get the nerve to calm down if it is irritated or inflamed? When this happens, I can feel a great sensitivity in the region where the episiotomy was done. Is there a way to calm this down? I wondered if poo can get trapped in a rectocele and cause irritation or inflammation. I read today about problems with those who have dry vaginas. I have ALWAYS had that problem and have used KY since I got married. Are "dry" people more susceptible to these prolapses?
Thanks for listening to the ramblings. I guess I need a shot of optimism today. I really do appreciate your comments. They helped a lot to understand why the whole area is affected.
Now I never thought of that
A couple of years ago I bought this new mattress (like a tempur one but not) coas every single day I woke with back pain...
New mattress - Well suffice to say it didn't do much
Looking back I cannot work out when the back pain stopped... I never even thought that posture could have stopped this!
Very interesting - I even went for an MRI on my spine to try to find out why it hurt (I never bothered to go for the results though as my the time they came through and I got the appointment the pain was gone)
Very interesting that posture could have done this. I also no longer watch tv all soucherama'd on the ever so soft suite - In fact I never sit on it any more, I find my computer chair much better in all ways - Though I rarely sit using its back.
An interesting thought...
Lord grant me the serenity to accept the things I cannot change. The courage to change the things I can. And the wisdom to know the difference
Look into the eyes - They hold the key.
http://www.bringmadeleinehome.com/img/maddy544x150Banner.jpg
Hi Tiddbits
Pain often is often not caused by something at the position of the pain. This is called referred pain, from what I can gather, and is often nerve-related. One of the reasons pain and other sensations in the vulva, perineum and anus occur is that these areas are all 'serviced' by the the three branches of the pudendal nerve. See my post on pudendal nerve entrapment. There are a heap of other nerves coming out of the lower spine and sacrum related to the pelvic area and muscles that are there as well.
Since Christine has made a very compelling case for the importance of the lumbar curve in her book and this site it seems logical to me that if the vertebrae of the lumbar region are 'unhappy' or not optimally used and positioned this might affect the other nerves coming out of this area as well (Nerves don't like getting stretched, and react by becoming inflamed. This can, from my reading make the body parts related to each nerve sensitive.)
The thing about lying propped up on pillows is that it forces the lower spine to slouch and the pelvis to tilt back so the pelvic floor becomes slack and cannot do its job properly. Hey, you can get away with it for a short time, but it is not a helpful regular habit for prolapses or any pelvic floor problems. Try sitting upright or just propping your head (and perhaps shoulders) up. The more entrenched WW posture becomes the more aware you become of when you are doing something to your body that it doesn't like.
Tiddbits, this living with prolapse business often does entail setbacks, but your body will usually recover in a few days with some TLC, and you learn lessons for next time from these setbacks. There are no magic bullets. You really do have to use all the strategies you can, ideally 24/7, but there are things we humans do that require us to break the rules every now and again. That probably doesn't matter. *Trying to optimise your posture all the time* is the main habit to establish. Allowing that WW posture to do its work also means leaving your belly with plenty of room to expand inside clothes, eating well so you don't get constipated, rethinking seating you use, exercising your whole body appropriately etc.
The other thing to remember is that progress is often so subtle that you cannot even see it until you realise 12 months later that, eg you haven't splinted for a bowel motion for several months, or that you haven't had any more UTI's for six months, things like that. The improvements just keep happening for me, eg I have just realised that I no longer have serious lower back pain in the mornings.
Hope these comments are helpful.
Louise
dealing with it
I was diagnosed with a rectocele about a year ago. I was discouraged with the pain and the "surgery is the only option" approach I was given. After finding this website and reading the experiences of others, I was encouraged.
I find myself concerned when symptoms flare up from time to time. You comment about lying propped up in bed as not good struck me because I had never heard of that before. Now I wonder if I am doing something to make the symptoms worse. Also, the comment about pressure in the butt interested me. Is this common with all prolapses? I read somewhere that rectocele can also cause discomfort in the bladder as well as vagina. Anyone have any info?
Thanks for sharing experiences. It helps a lot to know that others have the same struggles.
Other sources of education
Thanks for letting me know I'm not alone. I am now reading everything I can and have the second edition of Christine's book and her video and this site. On the internet, I have found little else, and I'd like to know what, if any, of the sources you have explored have been helpful. Thanks and good luck to you. discouraged
Inaction or action?
Hi Annette
An interesting closing sentence if ever I read one. ;-)
I think it is not so much inaction that you are embarking upon. You have obviously put considerable thought and time into your inaction decision as we all have, so in a sense it is conscious inaction, rather like 'Mahatma Ghandi inaction'. Inaction would be more like thinking, "This is just awful, too awful to even think about", THEN doing nothing.
What you have done is grasped reality firmly and stared it in the eye, looked at all your options (not the gynaecologist's offered options) and decided to take this very active path, where you will be managing your diet, managing your posture, managing your clothing and rearranging your lifestyle and environment. You will also challenge, and probably change your brain's attitudes to your body and what it 'should' be like. You are actually actively looking after your own body, and will be, for life. Welcome to the future.
The prognosis that we so often hear from gynaecologists (not all of them), "you can have surgery or do nothing", is simply the gyno saying that "gynaecology has nothing else to offer you. Your only other option is to do nothing". This is because these gynos have no knowledge of any other way of dealing with prolapse. They do not recognise any other world view. Pretty closed-minded, eh?
You have nothing to lose with Wholewoman work. You probably have a lot to gain, like so many of us.
Cheers
Louise
Encouraged not discouraged
Christine,
I'd like to tell "discouraged" that I'm probably at the same stage as she is, and after doing a LOT of reading on this site and elsewhere, I'm also deciding to leave well alone.
That also includes not wearing a pessary regularly. I have tried one for two months and it suits me fine, but I worry about the effects of wearing it continually for many years.
After reading Christine's book, I'm encouraged. I'm going to go with the posture and exercises in the book, eat well, enjoy life and just live with it. I no longer fear that it will worsen as a result of my inaction.
Annette.
Thank you Kit. I'm less
Thank you Kit. I'm less discouraged now, have begun to think that my cystocele is actually a natural way my body has protected me from having a uterine prolapse. Although things may get worse, I'm feeling that they may stay just the same. I had a dentist once tell me once that I should have a wisdom tooth taken out because it was going to have to come out some day if it gave me trouble, and he believed that would happen. Since it was not giving me trouble, and since it WOULD give me trouble if I had it removed, I responded that I would wait until that time came before wanting him to extract it. That was about twenty years ago and I doubt he will still be in business when and if it ever causes me any trouble. Have a nice weekend.
D
Dis-Courage-d, May I call
Dis-Courage-d, May I call you by your middle name? (smile)
According to TheLifePrescription.com ---
Procrastination - to put off intentionally and habitually.
Personally, I cannot think of a better plan.
Christine and her many petals of wisdom will be along again for you soon.
I’m just a little weed that pokes through from time to time.
I wish you sweet peace of mind this weekend. Kit
we are all...
Christine,
I was very interested to read this comment. I had been thinking about my gyn recently advising me to have surgery when I have no symptoms other than a slight bulge. My urinary flow is not affected, and I have no pain or other related problems. I had at that time been hoping that things had just gone to a sort of settling point and were going to stay static. I could certainly live with it. The Dr. said that there was a 50-50 chance that it would get worse and then, after doing a pelvic exam, stated that my uterus would have to come out too, and "why not?" since I was post menopausal. At the time it seemed to me that my cystocele was actually settled into holding everything else somewhat upright. Without it, my uterus would want to come down, also. So, I have decided to leave it and live with it as I have been doing. Surgery would make things worse for quite a period of time, and right now, nothing is disruptive. I sure hope that things have reached their zenith and that I am not making a mistake. I just feel that if things really do get worse, then that would be the time to consider the surgery, not now. I hope I am not just procrastinating.
discouraged