Lindsay was 4 weeks postpartum when she found out she had Pelvic Organ Prolapse.
This is Lindsay:
4 weeks postpartum, she found out she had Pelvic Organ Prolapse.
She remembers just feeling really swollen ‘down there’, like she was sitting on a ball every time she sat down.
She went to her OB, and was told that she had Uterine, Bladder and Rectal prolapses.
She went to her OB, and was told that she had Uterine, Bladder & Rectal Prolapse
Her doctor told her she would have to change her lifestyle. No more running, downhill mountain biking, no lifting more than 25 pounds – which would include her daughter as she got older, and the list goes on.
Her doctor gave her three different options: Kegels, Physical Therapy or Surgery. She chose to do physical therapy where he referred her to go to, but she got the feeling that her doctor thought she was hopeless.
She left that doctor’s appointment, feeling devasted, like her life was over.
Lindsay’s experience with her first physical therapist was awful. She did not think he knew what he was doing. After a month, she decided to find someone on her own.
She switched to a woman who had pretty good reviews in her area. Again, after a month, though, she felt like they were not making any progress. She had been doing all of the exercises as recommended, but saw no improvement. This second therapist, did do internal exams, but mainly ultrasound to see where everything was at, and didn’t really give concrete recommendations based on the ultrasound.
Two months after my diagnosis, Lindsay still felt lost. She was referred to an acupuncturist, by a midwife who said she had heard they might be able to help her. When Lindsay was at her appointment with this acupuncturist, after hearing about Lindsay’s struggles with the two other PT’s, the acupuncturist told her about me!!
This time, Lindsay did her research on what she was wanting out of therapy. She gave me a call, and asked me a long list of questions.
“I knew from that phone call that Dr. Kelly was going to be the PT who could help me get my life back.”
At our first meeting, I first,gave Lindsay hope that her active lifestyle was not over.
“Kelly did more for me in that first appointment than was done in the two prior months with two other Physical Therapists. Even though I had to travel to see her, it was worth it.”
Lindsay’s first appointment with me was in late November. I did a standard pelvic muscle exam which helped us ‘map out’ where she had muscle tightness, where she had muscle weakness, and where scar tissue and adhesions could be contributing to persistent symptoms of heaviness and buldging. Lindsay started exercises to both lengthen AND strengthen her pelvic floor. She also was working on improving her overall muscle control of her diaphragm, abdominals and pelvic floor muscles, trying to learn to control each group together at times, but also separately at times.
After two appointments with me, Lindsay checked in with her doctor to see what their prognosis was. She had improvement on her Uterine and Rectal Prolapse, but no change in Bladder. He recommended surgery on her bladder, and Lindsay had a pressing time limit, due to an insurance limitation, on how long she could wait to see if PT would work.
“I was going to be losing my insurance coverage in 4 weeks. If I needed surgery, I needed to decide now.”
At Lindsay’s next appointment with me, we discussed my options.
At that point, her deductible had been met for the year. The following year, her deductible was going to be so high that she wouldn’t be able to afford surgery, without it being a big stressor.
While I did wish that we would have had a couple of months to try PT before we had to come to a decision, unfortunately we didn’t have that kind of time. With my knowledge of the general trajectory of active individuals with triple-prolapse, I agreed with the doctor that surgery was indicated to support the damaged vaginal wall.
With that recommendation, Lindsay chose to move forward with surgery to support the bladder prolapse (anterior wall). She still worked with me in PT before her surgery, to make sure that her pelvic floor was supple and strong, and that her body mechanics were optimized, to increase the chances that the surgery would be a success. Her surgery was on Dec 17.
“I had surgery December 17. Dr. Kelly helped me determine that it was the right choice for me and my body.”
Six weeks after Lindsay’s surgery, at the very end of January, she came back in for her first post-operative visit. We did a reevaluation to see exactly where she was at. At this point, she was still having symptoms of pressure, but nothing like before surgery.
We started in with exercises to both lengthen AND strengthen her pelvic floor muscles, based on the findings of the pelvic muscle exam. Lindsay did her own internal work 2-3 days a week at home with either her own hand, the help of her husband, or a pelvic wand from Intimate Rose (pro tip, use website intimaterose.com/kelly21 to get $5 off any product) to help with muscular circulation work.
Up until this point, Lindsay was only wearing pads. Due to the feeling of pelvic pressure, she hadn’t been able to wear a tampon since the birth of her 3rd child, 8 months prior. Now, at 8 weeks post surgery, I let Lindsay know she was ready for tampons.
“It was an emotional day when I was able to wear a tampon again. I never knew I would take that for granted.”
Lindsay had a trip to Hawaii planned at the beginning of March, so I worked with functional strength goals to prepare Lindsay to be able to hike and surf while in Hawaii (3 months post-op). For Lindsay, at this time, it hurt to have sex, as well as to orgasm. Another functional of pelvic PT, was that in Hawaii, I would be able to resume sex and hopefully have it feel good.
In Hawaii, Lindsay was able to hike a couple of miles and surf. She had only the most mild pelvic pressure symptoms in the evenings, and in the mornings she would feel good again. She did try having sex, and while positioning didn’t hurt, orgasming still hurt and she was very symptomatic with pelvic pressure after.
When she got home, she resumed her work with me in Pelvic PT. With a triple prolapse, it was slow progress, but the progress was there. It sometimes feels like you take one step forward and five steps back. Still feeling symptomatic in the evening and all day about a week before my cycle would begin. Then the next month, it feels like you take one step forward and 4 steps back.
Finally in June (6 months post surgery), Lindsay took a step forward…and kept waiting to take steps back… but it never came.
Lindsay was released in June (6 months post-op), to downhill mountain bike, and carry her 20 pound child for 15 minutes. This was a huge victory for her. And she never looked back.
3 weeks later, Lindsday was able to go on a downhill mountain bike trip, was carrying her daughter hiking for 45 mins, road biking weekly, doing low impact workouts, and jogging to her mailbox and back. HUGE PROGRESS from a year earlier when her doctor told her that she would never run or mountain bike again.
Early fall, Lindsday’s only remaining symptoms wer emild pressure 1-2 days before her menstraul phase. We refined impact exercises for better load management (teaching the whoel body to absorb the shock. When Lindsay first started doing these exercises, she would feel a little symptomatic in the evening (mild pressure in rectum). After one month of working on those exercises, that complaint stopped and Lindsday was symptom free.
“Seeing Dr. Kelly every 2-4 weeks for 10 months was the best investment in myself and my health. I am now ready to continue on my own.”
This will be a lifetime journey for Lindsday, but while she is on this journey, she will be able to enjoy the things she loves.
I’m eternally grateful that I could be a part of giving that gift to Lindsay.
I REALLY wanted to include Lindsay’s story on this Blog, because while 4/5 women can successfully manage prolpase symtoms with PT, 1/5 needs surgery to stabilize the pelvic fascia. It doesn’t mean you’ve failed, or are weak…it means that the mechanical support to hold your lady-bits inside of you is so changed that you really do need a surgical stabilization to fix it. Outcomes are awesome, ESPECIALLY WITH PELVIC PT.
Look for an upcoming blog post on what questions to ask before and after prolapse surgery, and remember, in most states, you don’t need a physician’s script to see a PT. Find a pelvic PT near you, or establish with a remote pelvic PT you trust.
Follow me on Instagram for other free knowledge drops! And if you want to know what exercises Lindsay did, check out this post, about beginner core awareness activities, and consider purchaing the Signature Series, to learn how you can heal your pelvic floor, naturally!