pelvic floor damaged for ever? Older sisters help! PLEASE!!

Quick look at what has happened to me:

Baby at 19. Tore from vagina into rectum. 4th degree lacerations. Doctor sewed together but did no repair. I was told to do kegels but he never explained how important they were to keep my pelvic floor strong. I thought they were to keep the marriage strong.

3 yrs later another baby. Normal delivery,normal weight.........no problems. Pregnant again in 7 months. Normal delivery,normal weight,no problems.

Fast forward.......2 years ago I landed my job at a warehouse where I was lifting a lot of freight that was way too heavy for me. I stayed there a year but kept feeling like something was falling out. It was......almost 5 weeks ago was surgery.

I had uterine prolapse,cystocele,rectocele a&p repairs. I had to have my vaginal walls pulled up and my perineum was cut and sewed back together(dont know if that is a&p repairs or not).

Now here I sit. I have missed way more work than I can afford. We live paycheck to paycheck to begin with. I am hoping to get back to work October 8th. I got a call from my dr yesterday asking about Physical therapy on my pelvic floor. They call and order it and the clinic calls me. Basically making a long story short I need 12 treatments. At $100 for the first and $36.00 per 15 min......possible 45 min sessions(roughly another $100 per session)once a week. So summing it up here is the math......$1300.00 for 3 months worth of treatments. $400.00 a month. Thats half of what I make a month and my income is half of the whole family income. I simply can not afford it!

I am scared. Everyone tells me "oh all you have to do is those exercises to stop and start peeing" You dont need $1300.00 worth of therapy to teach you to do that. I can not feel those muscles. They feel dead to me. I can barely stop my flow of urine even after surgery. So what happens if I do not do this? Am I looking at another prolapse? Adult diapers? I am still leaking urine.......not near as bad as before but enough that I can smell it on my panties. Pelvic muscles are just like any muscle it gets weaker if you do not exercise it. I am reading and looking to find every exercise possible to strengthen the pelvic floor. I just dont know if doing them at home are going to be enough.The therapist of course stresses that the sooner you do them after surgery the better. So if I wait they arent gonna work? Is my bladder going to start falling again before I can get it done? I thought having surgery would make everything better. Why did I not know ahead of time that I was going to need this therapy and how much it was going to cost? I feel like I am in a hopeless situation here.

Someone Please chat with me about this. This is a problem that I am not going to be able to let go.

(((Lesa))) Your situation leading up to your prolapse sounds a lot like mine. Unfortunately, a weak pelvic floor can be hereditary and can be aggravated by those huge vaginal deliveries, as well as heavy lifting and hormone imbalance (including perimenopause). I had all those factors together, and it sounds like you had at least a few of them.

Yes, you would benefit from doing the physical therapy. Yes, it's likely that if you don't, you may experience further prolapses and incontinence at some point, which might require further surgery. $1300 seems a low price when you consider the alternative. However... do you have insurance that will help with the cost? Or will the therapist give you a break if insurance won't cover it? Is there another therapist that can do this at a lower cost? Do they offer financing? (Many do.)

Vaginal estrogen and testosterone creams can also help strengthen the pelvic floor when combined with these exercises. If you do go ahead with the physical therapy, I'd urge you to talk with your DR about using a little bit of both to help get the most possible benefit out of the therapy.

Good luck!
s,
-Linda

Lesa,

Your situation is a lot like mine. I was pregnant at 18 and gave birth shortly after my 19th birthday. My weak pelvic floor started during my pregnancy and I almost lost my baby when I was 5 months into the pregnancy because the weight of the baby was too much for my muscles. Thank God I was able to carry my baby another 3 months and gave birth only a month early. My doctor never said anything to me about therapy or exercises to prevent a prolapse and quite honestly at 19, I didn't know anything about it either.

Unfortunately, without taking preventative measures, I ended up with a prolapsed uterus, rectocele and cystocele which I lived with for 12 years until 11 days ago when I had a TVH with AP repair.

I'm glad you posted this because this gives me more to ask my doctor when I see him next week. The first thing on my list is actually how I can prevent this in the future because nobody told me in the past and I really need to know if I can prevent a future prolapse or if it's just my destiny. I know this does run in my family as many women in my prior generation have a prolapse of one thing or another. I will run all of this by my doctor next week and I'll post what he tells me.

I feel much better now that I had the hyster and the repairs but I still have an underlying fear that things will prolapse again and I'll be back in surgery or in adult diapers. I will do whatever I can to avoid either of those scenarios so I hope whatever I do will be effective in preventing future problems.

I'll keep you in my prayers. Please don't give up hope. Get a couple of opinions and check with a couple of different therapist and maybe you can get a break on the fee or a payment plan physical therapy.

Take care of yourself.

Karen

Lesa Hon,

I'm Sorry your suffering so. Sending Blessings and Prayers for a resolve to your health problems and financial ones as well.


Tender hugs,

Mich

I am six months out from the same surgery,pelvic floor repair.... I am just now feeling strong enough to lift more than 10 pounds and to push a full grocery cart. Try to take the time to recover. I am 54 years old. You sound a lot younger than me.

Hi, Lesa,

Make sure, when you call the PT facility, that you ask them what their rate is for people without insurance.

A lot of times, the rate for those with insurance is higher, than for those who are paying out of their own pocket.

It might be that the rate will be significantly lower, and affordable for you.

If not, then, you might see if financing is available. Lastly, you might find out if you can go for one or two sessions, so they can show you exercises that you can do at home - the first session, to show you *how* to do them, and the second, to ensure you're doing them properly, and see if you can cut down on the total number of sessions needed.

I hope this helps.

Sincerely,

Nana

Rhavensunflower...

I had a/p repair 15 years ago when I was 35 and after the initial bouts of enthusiasm never did a kegel ex again....You know how it is, life gets in the way.

In Jan I was dealing with a prolapse yet again and had a vag hyster and second a/p repair in April. This time I fully intend to keep up the pelvic floor exercises - for life, my surgeon recommends. I am certainly going to try!

Whereas I believe they are very very important, I am not sure that you need all that input from a physio. Once you know what you are doing and are doing it correctly, I can't really see the need for a 3rd party! People may of course disagree.

As to when to start, there are differences of professional opinion about this over here in the uk. Last time I was advised to start straight away after the op, this time I was advised to wait until 6 weeks. This was to give the muscles time to heal before hitting them with strenuous exercise. This made sense to me as, like you, I couldnt really feel those muscles properly until 6 weeks with the swelling etc etc. anyway. So don't think the muscles have given up already..they are still recovering from the assault of major surgery.

So, at 6 weeks I started and I am still doing very well. I can feel the muscles responding too and am confident I am doing the right thing. (You have to remember to tighten and lift the back passage as well)

Thinking of you...take care

Thanks everyone who has replied to this. I am grateful to everyone who has taken the time to give some input to this. I am especially grateful to Surferbabe. I was hoping you would reply because I have noticed through your posts that you are very familiar with what I am going through.

I have done a ton of research. The more I read the more confused and angry I get. This could have possibly been prevented. Then again I may have just been destined to have this no matter what. I do feel like better education for young women is a place to start. You can bet my daughters will be educated.

I have called the pt facility and the rate is cheaper for cash payments. I will get a 20 % discount. There are only 4 places in my state that offer this. The one I am going to is the closest to me and its 70 miles one way for me to drive. Even if another clinic was cheaper I would spend the money saved in gas. Unfortunately financing is not an option. I have no insurance.

I have got no choice. I am not just like the average woman who has had no trauma to her pelvic floor. Mine has been damaged twice. Because of that I am going to have to do more than just kegels. I have researched the pt and even found a site where my therapist is listed. It shows everything she teaches.

I am going to cough up the $100.00 for the first visit if I have to cash a hot check or sell something. I am going to discuss my finances with her and see if I can start out just doing the minumum. The first visit is $100.00 and after that it is $36.00 per 15 min. She said each visit is approximately 45 min. If all I can afford is the first 15 min then I figure that is better than nothing. I know I can learn to do the kegels with out 12 sessions of therapy. I can not however get the other types of therapy at home. I have had too much damage for kegels alone to help.

I would like to hear from anyone who has had the therapy with electrodes.

Oh (((((Lesa))))) I'm so sorry you've been through soooo much already... and here you are dealing with even more

I have a lot of the same issues to contend with: in the 1990's, I delivered two rather large babies (both over 9 lbs), vaginally. And both deliveries were very fast: 5 1/2 hours for the first, 1 1/2 hours for the second!!! This means that the damage to the pelvic floor was even more dramatic, due to the force of the births.

I was also told about the importance of Kegels, but simply couldn't do them: I had been sooooo stretched by my son's birth, that the kegels were totally ineffective. I simply couldn't feel them probably to perform the kegels.

What finally did me in was the huge fibroid that I carried around and lead to my hysterectomy. By then, I was dealing with a stage III rectocele. The rectocele was repaired at the same time as my TVH.

Fast-forward to 11 months post-op, which is when I started having increasing problems with stress and urge incontinence. Once I finally found a doctor who would take the incontinence problems seriously, I was referred to a urologist who then sent me to a Pelvic floor Therapist.

The therapy is performed through bio-feedback technology. This means that a probe is inserted in the vagina (some therapists also use a rectal probe). In my case, there was no pain involved with the therapy. The therapy is two-fold: on the one hand, impulses are sent to the vaginal muscles in order to stimulate them into contractions. On the other hand, the proble is used to measure the strength, duration and effectiveness of your own contractions. The objective is to, eventually, strengthten your pelvic floor.

I wish I had continued with the therapy: due to time constraints and budgetery issues, I only went to two sessions. Long enough to find out that they really work.

BTW, in my case, the first session lasted 1 hour and included an examination. However, the next sessions only lasted 30 minutes. To the cost of the first session, which, for me, was $90.00, was added the cost of the probe, which was $30.00. Subsequent sessions were $65.00. I'm in Canada, but this therapy is not covered by our provincial insurance plan. My group insurance does cover it... but, still, I have to pay it out-of-pocket and added to the $300.00 of meds for my DS... that's just too steep for us

Do mention your problems to the Therapist. And ask about alternatives. In my case, the therapy sessions were every 3rd week... but I was to do Kegle-like exercises, on a daily basis. The instructions were very specific: the kegles were to be done while lying down since doing them sitting up or standing was simply too much and too ineffective for my damaged pelvic floor.

Sending tons of s your way and hoping that you can work something out. Please, do keep us posted.

Lesa,

I don't know much about this topic...but am sending you lots of s and encouragement. I know that I had to charge some very costly medications once...and when it comes to your health it's worth it. I would also check with the medical group / doctor / facility / hospital to see if there is financial aid available. Sometimes there are donations or funds set aside for situations like this. I called Glaxo about my imitrex injections years ago, when my insurance wouldn't cover them. They were very helpful.

Hoping this works out for you. I'm sure it's very important.

Hugs,

Kim