Pelvic floor prolapse

Hi:) I spend most of my time over on the pain management forum, and had never known that this forum was here!!! I just can't believe it.  I'm sure I'll have a million questions, but will explain my medical issues for now.  I fell down the stairs on Christmas 2007...crushed my tailbone and damaged my SIJ (Sacro-Iliac Joint).  I also have lived with many uterus problems, and for almost all of 2008, I had my period every day.  We tried hormones, nothing worked, so after about 11 months, in Nov 2008, I had a D&C/Hysteroscopy which revealed an extra thick uterine lining and confirmed what we already knew, that I have a bicornuate uterus.  About 6 weeks post-op I stopped bleeding.  And then did not get a period until the day of my surgery to remove part of my crushed coccyx bone.  The day before my surgery, I had pain in my bum from my broken bones, but that's it.  The next day I realized I was REALLY swollen in my pelvic area...I thought it was just swelling from the surgery---but it was my cervix...right at the opening of my vagina.  And there were bulges on either side (my rectocele and cystocele)...
A consult with a urogynecological expert at Uof Michigan hospital said that I probably had a partial prolapse from having 3 babies, but the entire prolapse had to have been the result of the surgery.  
My coccyx surgery was unsuccessful for any pain relief, gave me a 13 week open wound from a staph infection, and a pelvic floor prolapse.  
I'm 34.  My doctor (OBGYN) has been really wary of taking my uterus because I'm so "young" but also because we have to wait to see if my muscles are strong enough on their own.  I assure my doctor that I need no more children, and that once my uterus gets out of my vagina, I may just let it stay empty for a while anyway:)
In June of this year, I had 4 unexplained fainting episodes, which have now been seen on an abnormal EEG to be seizure-like activity.  Everything to fix my prolapse and periods (because now for the last 3 months I've had a full period every other week)...It's all on hold, because they have to work on my brain.  My Neurologist told me today that I still cannot drive indefinitely.
The part I absolutely hate....the bathroom issues.  I can only empty my bladder if i press my fingers into my vagina and press against the bulge.  And for bowel movements, I have to press through the other way thru the vaginal wall...and many times have to even go into my rectocele to empty it out.  And I feel like my bowel movements have to make a U-turn to be able to exit...and since I am on narcotic pain meds, I do take lax-a-day to help things, but with the U-turn, it doesn't seem to matter.  And all of the pressure from the whole entire thing makes my sacrum area just throb and throb.  
I guess this sort of sounds like a pity party, and may sound graphic to some, but I'd love to hear how other people do in my situation or something similar? I appreciate all feedback, and thank you:)

[sherrieP]

So sorry to hear about this cluster of health issues, you are sure ready for a break! I truly understand your frustration with the elimnation issues, I spent more time on the toilet trying to figure out ways to get anything to come out (both pee and poop) than I care to say. I can offer some suggestions but to tell the truth, until the POP issues can be addressed, it will be bandaid suggestions.

First of all are you using a pessary? This will support the internal organs and may give you some ability to eliminate; it is by no means a miracle fix for inability to eliminate but can offer some relief, it can lift the organs up and with less pressure sometimes you can go a bit easier.

Since the urethra is typically crimped, finding a way to get urine to come out is tricky. I would massage my bladder area externally and eventually it would fall into the right position to pee. I did find that if I held off peeing until I really had to go bad it helped somewhat, but never really able to get pee to come out forcefully or completely. With the constipation issues, there are things you can do/use that may help a bit but nothing really fixes this since the colon has a "U" bulge in it where the poop gets stuck. You can try eating Activia daily, taking probiotics (I still take 6 a day even though I've had surgery because I have IBS), drink as much water as you can tolerate. Know that sugar and artificial sweeteners may make constipation worse and the pain meds really impact constipation issues but you need what you need. Do you take a stool softener? This is different than a laxative, it might be a good idea to talk to a pharmacist about which would be the best in your situation, you have to be careful with fiber supplements because they can  make the constipation worse in a situation like this. Stick with fruit for fiber like apples, pears, grapes.

Pressing through the vagina to assist evacuation is fine if it works for you, just make sure you wash you hands prior to going in so you don't give yourself an infection. So much extra maintenance to do with advanced POP but somehow we figure out a way to do what we have to do to get by.

Good luck, I hope things level off for you soon!!!!
Sher

[sherrieP]

So sorry to hear about this cluster of health issues, you are sure ready for a break! I truly understand your frustration with the elimnation issues, I spent more time on the toilet trying to figure out ways to get anything to come out (both pee and poop) than I care to say. I can offer some suggestions but to tell the truth, until the POP issues can be addressed, it will be bandaid suggestions.

First of all are you using a pessary? This will support the internal organs and may give you some ability to eliminate; it is by no means a miracle fix for inability to eliminate but can offer some relief, it can lift the organs up and with less pressure sometimes you can go a bit easier.

Since the urethra is typically crimped, finding a way to get urine to come out is tricky. I would massage my bladder area externally and eventually it would fall into the right position to pee. I did find that if I held off peeing until I really had to go bad it helped somewhat, but never really able to get pee to come out forcefully or completely. With the constipation issues, there are things you can do/use that may help a bit but nothing really fixes this since the colon has a "U" bulge in it where the poop gets stuck. You can try eating Activia daily, taking probiotics (I still take 6 a day even though I've had surgery because I have IBS), drink as much water as you can tolerate. Know that sugar and artificial sweeteners may make constipation worse and the pain meds really impact constipation issues but you need what you need. Do you take a stool softener? This is different than a laxative, it might be a good idea to talk to a pharmacist about which would be the best in your situation, you have to be careful with fiber supplements because they can  make the constipation worse in a situation like this. Stick with fruit for fiber like apples, pears, grapes.

Pressing through the vagina to assist evacuation is fine if it works for you, just make sure you wash you hands prior to going in so you don't give yourself an infection. So much extra maintenance to do with advanced POP but somehow we figure out a way to do what we have to do to get by.

Good luck, I hope things level off for you soon!!!!
Sher

[optimus22mac]

You cannot even imagine how it feels to be able to talk to someone who KNOWS what you are going through!!!  WOW!
My OBGYN and I have discussed the pessary, but he wanted me to get my MRI/EEG results from my Neurologist first before we did anything.  I'll be making the appt to see him later today...and we'll see what he says:)
Thanks so much for this great forum! POP is brutal--- but I now feel I have someone to talk to about it:)
I look forward to future conversations!

[sherrieP]

So glad at least the pessary path came up in conversation. Know that there are literally millions of women around the world with POP, we're a pretty big club-the trick is getting women to open up about it-working on it every day! Hang in there, I'm hopeful things will get level for you. FYI, a urogynecologist is the specialist for this disorder so if you shift to the pessary path and have difficulty getting one to fit properly, you might want to check out that path. (They can also advise you with other treatment options, and as far as surgery when and if that day ever comes, you truly should see a urogyn.)

One day at a time!
:)
Sher