August 2017

How do I remember – or more accurately how do I push myself to do pelvic floor training, every day? Several times per day…

Because the reality is that it is incredibly boring.

First of all (as I have been on about already) I cannot enough stress the importance of seeking professional help with pelvic floor training. Anyone recovering from childbirth – with or without injuries – but we should all do this type of training afterwards to prepare ourselves for the future as parents and for potential further pregnancies and births. (Of course even better to start before pregnancy!)

But it needs do be done right.

I naively thought I knew how to do it, but my women’s health physiotherapist very quickly identified what I was doing wrong and she coached me how to do the exercises properly. It is awkward, sometimes uncomfortable, and you feel vulnerable when you have an internal examination to check the strength of the muscles ‘down there’, but for your long term benefit it is worth it.

There are endurance type of contractions which are long, and should be kept for ten seconds – or longer. And then there are the short type of contractions which are aimed to be a quick squeeze, and then a quick relax. I was told to do my long squeeze and my quick squeeze ten times. At least. And then repeat it three times a day. At least.

Personally, I find it very difficult to relax the pelvic floor. So I need to not only do my ‘squeezing’, but I also need to focus extremely hard on the ‘letting go’ in between.

All this takes time. It requires me to focus. A lot.

The good thing is that you theoretically can do pelvic floor training anywhere, even when you are out and about and know one will be able to tell when you are doing it. At least if it is done correctly, as then no other muscles should be tensing up at all. This is all very good, but I find I still need my 10minutes or so of complete focus for the training to be effective. Even if I am sitting on the bus with my son for half an hour it is hard to get those minutes in, as there is always something going on when you are out with a toddler. And at home! If I lie down on my exercise mat to do my squeezing I can be sure to soon have my son sitting on top of me.

And on the topic that things are usually pretty ‘full on’ when you take care of a child, it is very easy to simply forget about the pelvic floor training.

So I have come up with a few cues to help me remember. For example. Every time I have a coffee I need to do one set of exercises. This is a good one because I like my coffee, and in this way I push myself to ‘earn’ it. I usually have 2 or 3 coffees a day and some of the training sets are sorted.

Another cue is that every time my son falls asleep, it is time to do some squeezing. He now sleeps once a day so I am sure to get one set done in the middle of the day. When he then falls asleep for the night it is time for another.

Lastly when I stand at a bus stop waiting for the bus, and especially if I have a good few minutes until it arrives (and my son is not too bored) then I do some more squeezing.

I won’t pretend that the above works exactly all the time and every day. It doesn’t. But it is a way to keep it in my mind and never forget about that it has to be done. I may miss it for one coffee but when I remember it I force myself to do more next time. But to be frank – even if I didn’t have the cues I have come to a point where the pelvic floor subject is hard for me to overlook. It may sound depressing but it is often the last thing I think about before I fall asleep at night… Although it could simply be because I sometimes end up trying to do my last squeezes for the day before I go to sleep but it usually doesn’t work when I am too tired. Again, I need that focus or it won’t be successful!

I kind of hate that it is on my mind so much and that I have to do this training – but I do have to do it – and I have had to come to terms with this idea. I cannot escape the fact that I need to take care of my pelvic floor, and not just for now but for the rest of my life.

 

 

 

 

 

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A small blue cube made of silicone.

This little thing suddenly became as essential in my life as breathing. The Cube is in fact a vaginal pessary, which basically is a removable device that is worn inside the vagina. It is designed to add pelvic floor support when these muscles are weak and to support any pelvic organs that have prolapsed. There are LOADS of different types of pessaries out there. My specialist nurse suggested to try this when she understood how important it was to me to try and go back to running despite my newfound ‘dear’ prolapse.

I tried various types (and sizes) of pessaries before finding one that actually worked, the ring shaped ones I started off with kept falling out. Therefore I was almost sceptical to the idea, and I definitely didn’t want to get my hopes up too much. But I was also open-minded about trying if there was something that could potentially help, even if it was just a tiny bit. I was already sick of the feeling of everything falling out of me so anything that could improve it, anything really….

I really didn’t expect it would make such a difference. But now when I have used it pretty much every day for 1.5 – nearly 2 years, I realise that I have become completely dependent on it. It works the way it should by supporting / lifting up the prolapsed structures and as a result makes my day so much more comfortable. It doesn’t remove it completely, and some days are better and some worse, even if I have it. But it generally improves the prolapse when worn. The only time I don’t use the cube is at night time and when I have my period, or sometimes when I only stay at home all day not doing much (although as a mother of a toddler those days are becoming rare!) But when not using the cube I can really tell the difference. I can more clearly than ever feel what activities aggravate the prolapse and what things I need to be cautios with doing. These are things like walking too much, lifting my son, hoovering the floor, blowing up a balloon, sneezing or laughing when standing….

And on days not equipped with the cube, I could definitely not go running.

My journey back to some sort of running (i.e. jogging) has definitely been saved by my cube pessary. I don’t think I would have been able to run (jog) at all without it. I may be wrong. But it would definitely have been an even longer journey than it has already been, this I am certain about. And I am forever grateful that I had this chance.

However. Has the cube made my pelvic floor Lazy?? Is it a bad thing that I have become so dependent on it  – am I just masking the problem by using it all the time? I am not sure. It has been discussed on various occassions with professionals and I have the impression it shouldn’t be a problem that I use it pretty much forever if I need to (or until a potential surgery in the future?!) if it in the meantime does the job. But I still keep thinking the thought. Am I doing my body – or more specifically my pelvic floor –  a disservice (long term) by letting it get used to the cube pessary?

It would be amazing to hear from others who may have experience of using pessaries, and what your thoughts on them are. How has a pessary worked for you if you use one and how you look at the future  – with or without it?

I know I have a few followers on the blog now, and would really love to hear from you!

 

 

 

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Who knew that you can get physiotherapy for the coccyx?!

I sure didn’t, but it turns out possible with a specialist Physio. In my case it was the same Women’s Health Physio I saw before giving birth. She was the one to later also confirm I had sustained a prolapse and I did lots of pelvic floor training with her, but the treatments she gave me were mainly to help with my coccyx issue.

I would not have been where I am today with that if it wasn’t for this physio. I went for sessions with her quite frequently in the first few months post-partum and they were often very awkward and very uncomfortable but the exercises, massage, manual therapy combined with my own homework eventually brought me to a point where the pain became manageable. It was a long and slow process, and maybe it was partly Time that ran its course in the injury healing, but I strongly believe I would not have gotten where I did without physiotherapy.

I also wish I had had the same opportunity when I first injured the coccyx 10 years earlier, as back then I was only told there was nothing to do about it, that I just had to live with it. Well, it is likely I still have to live with some degree of pain and now almost two years post-birth I still struggle to sit down for too long, it is still difficult to be comfortable on a sofa and I cannot lay down flat on my back or do certain abs exercises whilst seated/lying on the floor. I also cannot live without my dear pillow. I use it on my everyday chair at home and it comes with me when I go travelling and anytime I know I will be sitting a lot without many chances of changing position.

Socially awkward again – yes sometimes it is, but the pillow does a good job for me and I prefer to stay as comfortable as I can, especially as I now have a son now who depends on me. I am just so thankful that the initial agony I was in the first few months after giving birth eased off, as it would have been tough to cope with that for much longer.

And my lesson learnt is to not suffer in silence – there is often help to get and it can make a massive difference if you make sure to get it!

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