pelvic health, Pregnancy, Prolapse, Self Care

Pregnancy After Prolapse – The First Trimester

~Read where you left off here~

So the line was pink. I was officially pregnant. Again.

It happened so much faster than we had anticipated. It was no longer a debate of being ready, because ready or not, it was happening. One week after learning we were expecting our second little one, my husbands parents were scheduled to come for a visit. We debated whether or not to share the news, it was SO early after all, but we decided if this pregnancy ended prematurely, their support would be so needed, so we told them.

That just reinforced how great it was. They were ecstatic! Of course they were, what grandparents aren’t excited to learn they will be welcoming more grandchildren? I looked to my mother in law for support, my husband and his older brother are only 13 months apart after all. She reiterated what we already knew, it would be hard in the beginning, but so worth it. And we had planned it after all, it will all work out in the end!

Overall the first few weeks I felt pretty good. I still had energy, continued my workouts, and kept up with life. Things were great!

Then I was struck with vertigo.

I had cared for patients with vertigo, and knew it was awful, but I always thought they were over dramatic. But let me tell you, from first hand experience, it is all consuming. When you feel like the world around you is spinning, and closing your eyes just makes it worse, and you haven’t figured out what triggers it so it hits you randomly, it is hard. So hard. Even harder when you have a toddler to care for, and pregnancy nausea has hit. The vertigo was the worst in the morning, which, lucky for me, coincided with when I was feeling the most nauseated. The two just fed off each other and I felt awful. Caring for Nugget was even harder, because bending down or doing anything that required me moving my head out of vertical, set it off. Add that to nausea and it was a sure fire recipe for a trip to visit the porcelain throne. But I was lucky, after couple of weeks, it self-resolved. I didn’t really do much besides give into my salt cravings and drink as much water as I wanted.

But all the vomiting did a number on my core. The force required for that really puts some pressure on the pelvic floor, I now understand why some women leak when they throw up! I started having a lot of heaviness and discomfort. I freaked out. I was so worried that I was causing my prolapse to return and went to a pretty dark place. The combination of vertigo, with pelvic floor symptoms and exhaustion all added up to my headspace being all out of whack. I had a lot of very negative thoughts. There were many moments where I freaked out that I was damaging my body beyond repair. I even had really low moments where I hoped I would just miscarry so I could not worry about it anymore. I laid in bed crying, feeling like a terrible person and mother for wishing this very much planned, very much wanted, pregnancy away. The emotional turmoil you go through after being diagnosed with prolapse can really mess with you, and I didn’t realize how deeply, until then. It was like I was back to the day I was diagnosed, spiraling down a dark hole of ‘what ifs’, fearing I would never get out again.

I talked to some other moms they offered so much great support. They validated my feelings and helped me see what was really important – that I wanted this baby and I knew exactly what to do to get him or her here as safely as possible.

My symptoms waxed and waned over the next few weeks, and came to a peak around 11 weeks. I finally asked my prolapse support group, and they all suggested I talk to my pelvic floor physio. I mean, I knew I should, but I was in a bit of denial. I let my ego get the best of me, and thought I knew everything I possibly could, and there was nothing she could tell me that would help. But I emailed her anyway, and I am so glad I did. She replied quickly, and said it was totally normal to feel like that at the end of the first trimester. The uterus gets heavy, but has not come up above the pubic bone yet, so the entire weight of it is supported by the PF muscles. She reminded me to take it easy and it should pass, but to call her if I had any questions.

And she was right! Within a week, all my symptoms were gone! I even went on an 8 km hike up a mountain, and felt totally fine at the end and still the next day!

Then I was just tired.

So. So. Tired.

I never really noticed the exhaustion with Nugget, because I didn’t already have a kid and could sleep or nap whenever I wanted. Not the case when you have a 15 month old who gets up at 6 or 7 every morning. No sleeping in when you’re a parent, and even less so when your husband is working 6 or 7 days a week. This did not work out well with working nights. I work nights the majority of the time, and it was catching up with me. I started getting reflux to the point where I avoided eating because it felt like nothing ever left my stomach, I basically felt like my digestion came to a screeching halt. I started losing weight, which is the opposite of what you want to happen in pregnancy. Not to mention I was basically a zombie whenever I was not working. My poor toddler had the worst mom.

I talked to my midwife, and we agreed it would be best if I stopped working nights. I felt so guilty coming to that decision. I actually quite enjoy night shift! Plus, as a nurse, working nights is a bit of a badge of honor. I felt like I was being a baby by giving them up so early in my pregnancy, but I knew I had to do what was best for me and this baby.

It was like the clouds parted. I was finally sleeping at the same time every night, and sleeping through the night again. Before, with such a wonky sleep schedule, I was waking every couple hours because my body couldn’t figure out it’s rhythm. My reflux resolved, I had energy to exercise and play with Nugget again, and surprisingly my skin almost completely cleared up!

Moving into the second trimester, I finally started feeling like myself again.

Pregnancy After Prolapse (2)

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Pregnancy, Prolapse

Pregnancy After Prolapse Series – Am I Ready?

This series of blog posts will follow my journey after healing my prolapse from my first birth, into my second pregnancy and beyond!

After I was diagnosed with my prolapse at 8 months postpartum with Nugget, I was devastated (you can read about that here). I thought my life was over and I wasn’t sure if I’d ever be prepared, physically, for another pregnancy and birth. I was terrified of picking up my baby out of the crib, never mind growing a second one!

Then I went to pelvic floor physiotherapy, and subsequently healed my prolapse. Then came rewiring my brain to actually accepting the thought that, maybe, I can have another baby. I mean, ever since I decided that kids were in the cards, I knew I wanted a lot of them! Like, 3 or even 4!

Before I was discharged from physio, I made sure to ask her thoughts on pregnancy, birth and postpartum. She had zero concerns with me getting pregnant again, gave me some great advice for labour and suggested I come back in for a check up at 6 weeks postpartum.

So, I had the go ahead from the professionals I trusted, but was I ready? Emotionally, I was SO ready. When I was pregnant with Nugget, my plan was to have him, then start trying for number 2 at 8 months postpartum, so they could be super close in age. Well, obviously, that didn’t happen. My husband wasn’t quite as antsy as I was to have babies right on top of each other, and I was still nervous about my body. I had felt betrayed and needed to learn to trust it again before taking on the challenge of pregnancy.

So I focused on getting strong. I started a new workout program, committed to working out every 2-3 days and for probably 2-3 months I stuck to it. I loved it. I was so happy with how my body felt, how my clothes fit, and how I felt in general. My body finally felt strong again. All of my muscles had blossomed, my core felt so supportive, and I was finally feeling like myself again.

I was ready. My body felt ready. My husband was ready.

It was time.

It took 9 months to conceive Nugget, so even though I was ready to start trying, I had absolutely no expectations for it to happen anytime soon. I was okay with that, prepared for a long road ahead.

Still, I did all the things. I peed on sticks. I took prenatal vitamins. I tracked my basal body temperature. I even tracked my mucous.

But even then, with perfect timing, most couples only have a chance of conception of 20% for any given cycle. Like I said, prepared for a long road.

We didn’t want to put our life on hold to have another baby, so we kept living it. We used the hot tub, we drank our fair share of wine, beer and coffee, we didn’t change our diet or exercise regimes. We just lived our lives.

I was so prepared for it take months to happen. After all, it had the first time, and nothing had changed in that department, as far as we knew, besides being a couple years older.

And then, two months in, it happened.

The line turned pink. The stick flashed ‘pregnant’.

Next thing we knew, we were preparing to be the parents of two under two.

{continued here}

Pregnancy After Prolapse

 

Birth, pelvic health, postpartum, Prolapse

How I Healed my Prolapse (Part 3)

Continued from Part 1 & Part 2

After seeing Kristen, I felt so much better. I wasn’t worried about picking up and carrying Nugget around, I wasn’t worried about carrying laundry up from the basement or hauling in groceries. I was able to actually live my life.

I started doing the ab work Kristen suggested, and I was absolutely astounded at how effective they were! Who knew such tiny movements like lifting your foot off the ground could have such a dramatic effect. The first day I did the exercise for a total of 6 reps. I know, barely anything, but I wasn’t able to maintain proper technique after 6 so I stopped. The next day I was blown away by how sore I was. We went grocery shopping and I was waddling around like I was 9 months pregnant because my TA was so sore! It was a total lightbulb moment for me. It made me realize just how much your TA functions in supporting your pelvis and trunk through every day movements, like walking! It made me understand further how diastasis recti can influence your movement and why it is so important to keep it in check if you have one.

I did the PF progressions she suggested. I was surprised to hear she suggested going PF contractions with a full bladder, but if you think about it, that’s like an internal load on your PF, and it’s like adding plates to the barbell! I was able to get even more in tune with my body, and really feel how and when my PF was contracting and monitor the forces at work.

I went back to see Kristen a month after our initial appointment feeling great. I informed her that a lot of my symptoms had subsided and other were explainable by reasons besides prolapse. She laughed “well you can go home now!” she said, jokingly, but I probably could have. She reassesed my abs, alignment and PF. After she was all done she said “Well you’re boring! There isn’t much going on here! Your PF is strong and contracting reactively and is well coordinated with your TA. Your anterior wall is ‘stretchy’ but I wouldn’t say you have a prolapse!”

I wanted to cry, again. But this time tears of joy.

But I hesitated. I was worried. Nugget was my first baby and I definitely had plans of having more, and hopefully sooner rather than later. So I asked Kristen what to do. I was nervous another labour and birth would do even more damage. Should I come see her in pregnancy? How does she recommend labouring and pushing from the perspective of a PT? Can I prevent prolapse with future babies?

So many questions.

We had a lengthy discussion about labour, pushing and delivery. It was so nice to talk to someone openly about birth who was about the function and physiology of the female body, and she gave me tools to go into my next pregnancy & birth feeling strong and confident.

And that’s how I want you to feel. Strong & Confident

Not broken, or fragile, or sad or depressed.

Strong.

We are all strong, we just need to see it within ourselves.

Now if you have read this series of blogs, hoping for a how-to list of things to do to heal your prolapse, I am sorry that I didn’t deliver.

However, I will give you this one To Do.

Find a pelvic floor physiotherapist. A good one. One that supports your goals and lifestyle. Not all physios are as open and supportive as Kristen, and you don’t have to accept that. If your physio refuses to give you progressions, or only tells you your options are to swim and walk, never lift anything over 5lbs (that’s realistic) and never spread your feet wider than hip width, find a new physio. There are good ones out there. If you don’t leave your appointment feeling confident you know how to live your life without fear and anxiety, you need a new physio. They should support your goals, not crush them.

 

how-i-1

Birth, fitness, pelvic health, postpartum, Prolapse

How I Healed my Prolapse (Part 2)

Continued from this post.

Luckily, I was able to score a cancellation with Kristen, otherwise I would have to wait months agonizing over my broken body. I was able to get in to see her two days later.

Now, I have never met a physio I didn’t like (true story), but there was something about Kristen. We just clicked. Our personalities were totally in sync and we had the same values and beliefs. She started the session by reassuring me, she could tell I was nervous. She said she knew many, many women who had a similar diagnosis to mine, and who live complete and normal lives, that I shouldn’t let this hold me back.

She assessed my alignment, my musculature, had me squat and stand while feeling my back and sides to assess how my muscles engaged. She had me lay down and assessed my abs and glutes, and informed me that my transverse abs aren’t as strong or coordinated as I thought, but gave me exact steps how to correct them.

She then did an internal exam (which I describe for you here), which I was most worried about. You see, the physician who had diagnosed me with prolapse had informed me that my pelvic floor (PF) muscles were extremely weak. She had rated them 1.5 on a scale of 5. She described it as barely perceptible with no endurance. The problem I had with that assessment is she didn’t allow me to coordinate my contraction with my breath, it was more “aaaand GO! NOW!” and I was a bit caught off guard. When Kristen assessed my strength, she allowed me to exhale with the contraction and take my time. She almost laughed when I told her the doctor told me my PF was weak, she rated me at a 4 out of 5!

I left the appointment feeling so much better, relieved that my PF wasn’t weak, and looking forward to moving on with my life. I booked another appointment for a month out, just to follow up with the ab work she gave me and the PF progressions she had suggested. Kristen encouraged me to call her with any questions, and unlike some professionals you speak to, with her I knew she really meant it.

The next day I had a thought. She never gave me any limitations for movement or exercise? Everything I have ever read online about prolapse is a list of don’ts. So I sent her an email, and fully expected it to take a week or two to hear from her, if at all. A few days later, she phoned me at home. The first thing she said was, stop Googling. She doesn’t consider postpartum prolapse in the same category as post-menopausal prolapse because there is so much at play postpartum. Your body has so much healing to do, and especially if you are breastfeeding, that can take a really long time, and to be patient. She told me to not limit myself at all because I have a strong PF and to trust myself, use good form and breathing and listen to my body. She suggested I do what I would normally, ease back into things, and if something exacerbates my symptoms, to maybe back off a bit next time. She didn’t see the value in restricting a young mother like myself.

This was the best thing I could hear. Instantly vanished any fear I had about carrying Nugget around, about doing daily activities, going for long hikes, or getting back into weight lifting.

I was happy again.

~Stay tuned for my progress with the exercises Kristen gave me, and how our next visit went and what she told me~

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