Bladder and bowel health

Christy, 37 (anal sphincter repair, bowel incontinence)

I never thought at the age of 37 I would be incontinent. It happened after a complication of a minor surgery I had, which resulted in a complete tear of the anal sphincter muscle, leaving me completely incontinent. First I was in denial, thinking that after the sphincter muscle had time to heal after surgery, I would get my proper function back. But that’s not what happened, the muscle never healed. I was permanently incontinent. And to make matters worse, many surgeons I consulted with told me this was a permanent condition that I’d have to “learn to deal with it.” But how does one just learn to deal with being incontinent?

I was referred to pelvic floor physical therapy by my surgeon. She felt it would be an important tool for me to have after my initial surgical recovery was over. Four months after surgery, I had my first appointment. Up until this point, I was struggling to get through everyday. By day’s end physically and emotionally I was drained. Physically I was in pain and uncomfortable all the time. Emotionally I was constantly worried about the effects of being incontinent. I was sad, stressed and somewhat depressed. The toll this whole thing took on me was enormous.

But after I left that first appointment, I felt much better emotionally. I felt like my therapist truly understood what I was going through and that I was no longer alone in this. It was a relief that I could discuss something as sensitive and personal as this to someone who was knowledgeable and compassionate about my condition. I had a very complicated situation and my therapist spent a lot of time thinking about my problem and helped me through a lot of the issues I had to deal with on a daily basis. And as the weeks went on, I’m happy to say that physically things got much better too. The pain got better and my quality of life improved dramatically. I no longer feared normal daily activities and my day to day life.

I am lucky that I was referred to pelvic floor physical therapy, and that I’m on the road to recovery. I can't imagine where I’d be today without it. I hope that more physicians will utilize this important tool for patients.

Donna, 51 (bladder complaints, multiple sclerosis)

I was at the end of my rope when I arrived at Marathon for Pelvic Floor Therapy. I had given up on ever having control of my bladder. I had experienced an Urodynamics test and had tried every medication that promised to end bladder urges and loss of control but nothing had worked for any length of time. Having experienced several incidents involving sudden loss of control of my bowels in public before my MS was diagnosed I wasn’t too concerned about constipation initially, but once I began taking a medication that CAUSED constipation, I was in serious difficulty. After my new gastroenterologist had ordered every imaginable test and the results were inconclusive, she sent me for Pelvic Floor Therapy. I had no idea what that meant and it took me several sessions with my therapist to ask, “Where exactly are you putting your finger?”

Matters became somewhat clearer when she handed me the model of a woman’s pelvic floor, but I had so little sensation in that area, I felt quite pessimistic about sending signals to a mysterious part of my body, but her instructions were so specific and she was so encouraging that I continued doing what she told me to do. Her instructions about how to strengthen my quads and some other muscles that had become weak were very clear and that progress was encouraging, so I persevered.

My physical therapist kept saying that the process took quite a few weeks before I’d see any significant changes, and eventually I found myself having “normal” bowel movements and being able to wait a much more normal amount of time between trips to the bathroom to urinate. I never expected for my bladder to be able to hold a significant amount of urine, but that has happened too.

This change in the way both my bowel and bladder functioned occurred in a little more than two months and I'm incredibly grateful. Thank you, thank you!

Erin, 56 (pelvic organ prolapse, conservative management)

For several weeks I had been vaguely aware that there was a sensation of fullness in my vagina. It reminded me of how a poorly placed tampon used to feel. Then I had the shock in the shower of finding that indeed there was a strange mass in there. Since menopause had occurred two years before, it was definitely not a tampon. What could it be? I raced to the Ob/Gyn fearing the worst. It was not a tumor. My bladder was prolapsing! I could not understand how this could be happening to me. I had delivered 3 children by completely unmedicated natural childbirth, during which I had been extremely careful to void my bladder all through labor, and had not had an IV. I had also always been diligent about doing Kegel exercises, and prided myself on being physically fit.

The Ob/Gyn said: "There is a surgery to correct this problem. Would you like to meet the surgeon? He is a great guy and a wonderful surgeon" I replied that there was no one else that I was less interested in meeting, and that surely there was a PT (physical therapy) option to try first? She reluctantly referred me to Marathon Physical Therapy while "reminding" me that there were ligaments involved that could not be repaired with exercise of any kind, and that she thought that my chances of success with PT were "very limited." I researched the surgical option online. From my point of view, it seemed a miserable surgery with a significant risk of lifelong pain that is irreversible.

I went to Marathon in a profound state of anxiety that is hard to describe. My physical therapist calmed my fears and assured me that with diligence I could get the situation under control. In the first week of PT my bladder actually peeked outside my body one evening. I was distraught and completely flipped out, but in the morning my PT calmed me down and set me on the right path.

Everything is now 100% where it is supposed to be, with no surgery, pain or risk. I learned from my PT that I had been doing Kegels the wrong way. She provided exercises that strengthened surrounding muscles. Today, my exercise regime takes five minutes in the morning,before I get out of bed and 2 minutes at night before falling asleep.

After I concluded PT there was a followup visit at the Ob/Gyn. She was amazed at my improvement and her incredulity was extremely obvious. She said that "most people opt for surgery." The only reason for this can only be that most people do not realize that PT is an option. I told her to send her patients to physical therapy, and that I am sure that they will find her even nicer than the "lovely surgeon," because in addition to wonderful bedside manner, she can help all women of every age and situation improve their pelvic floor health if they are willing to invest a small amount of effort.

Fay, 59 (pelvic organ prolapse, surgical management)

In December 2010, I started to experience a very strange symptom. While exercising, whether it was Pilates, sit ups or using weights at the gym, I started to feel a very funny sensation between my legs like there was something protruding from down below. I continued to exercise despite this but the feeling never went away. I am a very active person; I enjoy gardening, golfing and other outside activities, I exercise to stay healthy and this problem was an annoyance since it was interfering with the things I loved to do.

In the spring of 2011, I did some heavy lifting and there was that feeling again, but this time, significantly worse. So I decided to take a mirror and look to see if there was something actually there. Lo and behold, there was! It was a bulge of pink tissue in my vagina that I could actually push back up. I knew I wanted to pursue treatment for whatever this was, especially since I work as a Medical Technologist at a lab, where standing on my feet on cement floors would also make that bulge/pressure feeling significantly worse by the end of my 7.5 hour shift.

I went online and through reading multiple sources on the internet, I diagnosed myself with some type of pelvic organ prolapse. I saw a local gynecologist who confirmed that I had a uterine and bladder prolapse. She fitted me with a pessary and I felt like a new woman! It relieved all of that awful pressure and things felt like they were back in place where they belonged. However, as great as the pessary felt, I had a hard time removing it to clean it. The gynecologist said if I was willing to travel she knew a fantastic urogynecologist and recommended that I see one of her former classmates, Peter L. Rosenblatt, MD at Mount Auburn Hospital in Cambridge, MA.

When I saw Dr. Rosenblatt for my initial consult, he also confirmed my uterine and bladder prolapse. After discussing my options, I knew in the long run that surgery was going to be my best option for correcting this problem.

My surgery was scheduled for October 31, 2011. And as I’m sure all of you all remember, we had that much unexpected snowstorm on October 30, 2011, which left my house with no electricity! I had to go to a friend’s house to do my pre-surgery prep. My experience at Mount Auburn Hospital was exceptional from the get-go. Dr. Rosenblatt removed ¾ of my uterus (which was performed vaginally) and then performed a sacrocolpopexy, which is a synthetic mesh that supports the prolapsed pelvic organ (mine being the bladder) and attaches to the sacrum (tailbone). This is a laparoscopic procedure, I had 4 very small incisions in my abdomen and one at my belly button, all covered by band aids. I was wheeled into my recovery room at 6:30pm that night and at 7pm I was up and walking! I was encouraged to walk as much as I could the next morning and I was doing laps around the halls. I was so surprised and thrilled with the fact that I had no pain! I could stand straight and that bulge/pressure feeling was completely gone!

I was discharged home from the hospital the next day after the surgery and I was still amazed at how great I felt since I had heard some not so great post-surgery stories from other women. I was instructed to continue walking as I felt able but not to lift anything heavier than a gallon of milk. The hardest thing for me post-surgery during those 6 weeks of recovery were to not lift my 2 month old grandson but I was able to hold him if someone placed him in my arms. Within being home for 2 days, I continued to walk and was eventually able to resume walking 4 miles and was feeling fantastic! I did experience some mild urinary leakage immediately after surgery but that resolved quickly. I returned to work ½ days 1 week after surgery and back to my full work schedule 2 weeks after surgery and continued to feel great. If I had more of a desk job, I probably could have returned to work a few days after surgery but since my job requires me to be on my feet I waited a little longer. After my 6 week follow up appointment with Dr. Rosenblatt, he removed all restrictions and I resumed gardening, golfing, exercising and was able to lift without any problems.

Having this surgery was the one of the best decisions I have ever made. I didn’t expect such a great, painless recovery process since I had heard of failed surgeries and other troubles that go along with having a bladder suspension. Now, I feel like I did 2 years ago before that day when that “funny feeling” started between my legs. I would like other women who are at that crossroads of deciding to have surgery or not that it is so worth it! Don’t put it off if you and your doctor have tried other conservative treatment methods and know that surgery will correct the problem. I am a very active person and knew that I didn’t want to live with that “funny feeling” down there and have it worsen and cause other problems. There are success stories like mine out there and I hope that other women will learn from my story and have the same wonderful experience.