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.

 

 

 

 

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