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Pelvic Prolapse
my very personal journey
Warning: Some of the
links in the following show graphic pictures or drawings of physical
conditions listed.
After many years, births of
eleven children, including a couple of difficult deliveries, and
much pelvic pressure, I began the journey to restored health through
a surgical process to repair my complete pelvic prolapse. This
page will serve as sort of a journal, sort of a source for
information and links to descriptions of conditions, solutions and
procedures used in the correction of pelvic prolapse.
Pelvic prolapse is a general or broad term that may include
conditions known as
vaginal vault prolapse,
cystocele,
rectocele,
enterocele, prolapsed uterus or bladder, the urinary and/or
bowel incontinence that are results of the prolapse(s).
I underwent the surgery which
took a couple of hours and required a two night/three day stay.
The recovery time is 3 months of rest and very limited activity.
I do not believe I could have undergone such a surgery and recovery
had it not been for the support of my husband and family.
The journey began initially
with a visit to my Gynecologist who did an initial pelvic exam.
Her recommendation was that I see a Gynecological specialist/surgeon
and a Urologist. Since those doctors work out of a hospital
that requires a bit of a drive, I made appointments to see the
two doctors on the same day.
The urologist was very
sensible and businesslike. Her exam was not painful and because of
her experience and expertise, she immediately diagnosed my problem
and was ready to do surgery to lift my bladder and urethra. My
appointment with the Gynecologist followed. She was not so
eager to move ahead so quickly. Her recommendation was for me
to use a
pessary. A pessary is an "appliance" that is inserted
internally and for the purpose of holding up prolapsed vaginal
walls. I will say that this was no solution for me. It
was painful and not at all effective. It hindered elimination
of bladder and bowel. It was not a solution a second try with
a different type of pessary, nor was it with another try with a
third type. From what I have personally experienced and from
what I have read subsequent to that experience, I would never
recommend a woman using a pessary if she has a rectocele (a prolapse
of the bowel into the posterior of the vaginal wall). This was
very objectionable and I could not bear it---and my reading since
that time has indicated exactly what I experienced---and it was
unfavourable.
Because I didn't feel the
doctor was "tracking" with me---though I am sure she's a very good
doctor, it was just not necessarily a good "fit." I then made
an appointment to see another doctor on staff. I chose her
simply because of two things.. first, I desired to have a female
doctor and second, she has a great name: Dr. Storck. Now...
after eleven children, I felt I just *had* to meet the Storck.
After making my appointment, the nurse said I had made a good
choice: Dr Stork is Chief of Staff. my confidence to proceed
was bolstered.
I did see her and explained my
continued situation and added information to what she had read in my
chart. After another complete examination, she sought to do a
uterine biopsy because of the condition and size of my
uterus---which is apparently very large. The biopsy
results were negative and the size and irregularity is do to the
number of children I've borne and many uterine fibroids.
The presence of the fibroids explained the long and heavy periods I
have experienced in the last few years. This problem
apparently will subside during and end after menopause.
Plans began to be made for
surgery---both doctors required extensive pre-op appointments with
blood work and consultation with the surgery nurses. In addition, I
had an appointment with the Anesthesiologist and was evaluated for
surgery.
I was given some pre-surgery
instructions and obtained the items they requested me to get.
One was an enema which I was to use the night before surgery
(following two days of a very light/clear diet) and nothing to eat
after 11pm the night before surgery. And the other was a
medicated douche that I was to use the morning of surgery following
a thorough washing/shower.
Since I had previously filled
out all the paperwork (a step very much worth taking as it
eliminates much anxiety the day of surgery) my admittance to the
hospital was very smooth. Upon admittance, I was fitted with
an identification wrist band, and a band for the dietician for no
food. I was taken to the hospital room where I would stay
before and after surgery. I was given a gown and was asked to give a
urine sample for a last minute pregnancy test and then I waited
there with my husband for the surgery nurse to take me to the OR.
Once there, I was fitted with
anti-embolism stockings
or TED hose (I had requested these long in advance and they noted
the request in my chart) and an IV was inserted into my hand.
A catheter was inserted into my urethra and into my bladder (this
remained throughout my hospital stay).
I must stop and note here a
problem. My IV apparently had
perforated my vein and a bit of the fluid entered the
surrounding tissue. I thought the *burning* was "normal" and
dismissed it. (though, over the following two days I mentioned
it to numerous nurses who replied that the sensation I was feeling
was "normal." It was *not* normal---but I did not know that at
the time. Prior to surgery, I quickly dosed off to sleep and
was not aware of the pain---and actually remained somewhat unaware
of the extreme intensity and numbness for a couple of days due to
the morphine and subsequent pain medication. My personal
advice: if your *ever* feel like something isn't right, speak
up. Speak up louder and seek a solution. Do not be
"polite" and bear it---some problems *need* attention and
correction! Some pain can be alleviated in alternate ways or
with a change of pain reliever. Morphine is common, but that
might not be the appropriate drug for every patient.
The next thing I knew, the
surgery was complete and I was back in my room with my husband
sitting at the foot of my bed and a nurse was taking my "vitals."
I was closely monitored every couple of hours for the first twelve
hours post op. During that time, I had an IV for fluids and
was given ice chips. I had ice beneath me and on my
abdomen to reduce swelling. I remained in that condition for
the first twenty or so hours---the nurses changing the ice packs and
IV fluids. The day following my surgery, I was given foods on
a clear diet. And the next day it was liquid foods. Popsicles
were especially welcomed---I was not hungry for much else.
My doctors came to see me,
check my incisions and swelling, etc. and on the third day I was
discharged to go home. The catheter and the IV were both
removed and with help, I was able to stand up and walk to the
bathroom. I couldn't void properly. The catheter which
had been removed earlier that morning had to be reinserted because
an ultrasound showed that my bladder was not emptying---300cc's
remained! And so I went home with a catheter in place.
This was not at all difficult or uncomfortable. In fact, it
made resting at home very simple. I returned to the hospital a
couple of days later to have it removed and to be checked.
Returning home again, I went
back to bed. Because I had had no bowel movement, I was given
a double dose of milk of magnesia. This (several hours later)
was *powerfully* effective. My gracious husband helped me with
the clean up process. After that, I remained in bed for a full
week---only occasionally getting up to sit in a chair for a few
minutes or to walk around the kitchen and then back to bed. My
husband helped me with a shower most afternoons and the rest of the
time I simply stayed in bed either partially sitting or lying down
sleeping. I was told to take stool softeners for several weeks
and to drink lots of fluids. Additionally, since I lost a lot
of blood during surgery, my attention was to be on rebuilding
iron---a tricky thing to do when constipation is a consequence of
some iron rich foods and supplements. I had to be careful
about the amount of liquids I was drinking so that I would get
plenty without over doing it. I needed to get my bladder into
a routine---elimination was still a minor problem.
In the days following, I
experienced many emotions---from despair to joy, from fear of
never getting well or being free from pain again. I felt
sorry for my husband who was experiencing excruciating pain from an
incomplete root canal on an abscessed tooth. He never
complained, nor did the children. It was all in my head, but
it was very real to me, nonetheless.
Ten days after surgery, I
returned to the Urologist's office to have the ten staples removed
from the two incisions that were made to accommodate the "Monarch
sling" that was done to suspend my urethra. The removal
process was quick and not really painful. The momentary pinch
did not cause undue discomfort. All the other incisions were
sutured with slow dissolving material and the mesh used simply
becomes part of the internal tissues. The perineal muscles
that were layered to form a new perineum also have slow dissolving
sutures---at two weeks, the perineum area was the only very
uncomfortable problem and seemed to cause some difficulty in walking
comfortably or sitting very well for lengths of time.
Thoughts from my journal
A view from the chariot. One week out.
Day after day I've enjoyed a changing view as I gaze out through our
bedroom door and through the dining room windows that provide me
opportunity after opportunity to reflect on God's infinite grace and
the majesty of His creation. Each day as I look about our bedroom
and
the surrounding beautiful bouquets and vases of flowers, each
distinct with their unique design and fragrance, I am again humbled
by God's mercy and His awesome creation. One of my most favourite is
the hydrangea that Kelli brought to the hospital while I was in
surgery.
Timothy just took it out and planted it in a flower bed---where I'll
love watching it grow.
As I look around me, I see the elegant white
tulips and they seem to gracefully bow before the LORD, and then the
magnificent bouquet from my mother... alstramaria---lots and lots of
them in variegated shades: seemingly dancing, yet standing still.
Wes brought a most spectacular bouquet of long stemmed roses in
every colour, they seem to almost be showing off in the tall and
heavy crystal vase. The vases of assorted flowers, the beautiful
basket of pink, lavender and purple flowers delivered from the
florist---a gift from my mother in law, sits on my side table---a
constant reminder of her presence here. On my table right beside me
sits a round vase; a tight bunch of short pink roses and baby's
breath tied with a wide pink ribbon. Out on the dining table,
the sunflowers standing in a very tall pitcher seem to be a promise
of the warmth of summer ahead. The tulips and then another vase of
blue iris and yellow daffodils from the children remind me of the
handiwork of the LORD---both in and through themselves and in the
flowers---the once seeming dead, dried out clumps---the tulip,
daffodil and iris bulbs that produce the stunning flowers--- are
amazing to me---they point to another breathtaking thought: God's
amazing design for human life and His tender mercy over and His
perseverance with all of His creation.
A week ago I underwent surgery and have remained in bed since coming
home from the hospital. And so it goes---a view from the
chariot---well, not a chariot that's going anywhere, but my chariot,
nonetheless, that carries me through these days: our iron canopy bed
has twinkle lights wound around the vines around the top to provide
a very delicate glow of light. Wes kindly brought the laptop to a
little table beside our bed thus providing me a second view; the net
and news, articles and email---in addition to the view through the
dining room to the outside, I have a window to the world through
this computer. I'm missing my office in the tiny sunroom---I'm
missing the freedom to keep house, to help the children and to do a
myriad of other things that fill the days of a wife and mother.
The view two weeks out: [The first
"informational" part of this page was written at two weeks post-op]
3-8-06
Now, at nearly three weeks "post-op" I am still recovering.
Some days are easier than others. I have very little actual pain at
this point. I suppose the pain that resonates from my perineum
is still somewhat troublesome---especially when I sit on different
surfaces, but for the most part, the pain is minimal.
3-30-06
Now, at nearly six weeks "post-op" I am still recovering.
Sounds like my entry at three weeks. Amazingly, I feel little
difference between then and now. I am less sore, but all still
experiencing a great deal of soreness in that one troublesome area
my pelvic floor---no, make that two: that, and my arm.
I had two doctor's appointments this week; one
with the Urologist surgeon, and one with the Gynecologist surgeon.
Both appointments went well---and as doctors go, these are two very
nice, cordial doctors. They were brief but relatively thorough
visits. Routine questions and procedures to ascertain general
health and the healing process. Internal exams revealed that
healing is going as expected. Apparently where some of the
incisions are not yet healed is where my greatest soreness is
experienced. I guess I should be grateful that everything is
going well instead of dwelling on the length of time ties all seems
to be taking. 4-04-06
I had my first ride in our family van yesterday. Though Wes
had made a step stool for me and carefully helped me into and out of
the van, I see why the three month restriction for all sorts
of activities has been set. After our family outings, I was
very sore and glad to be home and back to bed. Today was
a slow day as I rested from the busy day yesterday. I kept thinking
all day how grateful I am to have had such tender-loving-care
throughout the last 6 weeks. I do not know how one would
handle such limitations without continual help in the home and with
chores, errands, etc. It is surprising how much we take for
granted and how little attention we pay to the abilities God has
given us. I pray to never take lightly the great gift of life,
movement, work, etc. |
