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Since joining Instagram and connecting with numerous physiotherapists for prolapse, I was really optimistic for this appointment. I was also so grateful that even during covid they had chosen to keep the face to face physio appointments running in the UK. However, in the back of my mind, I was still nervous about the possibility she was going to have to do an internal examination, which usually hurt. Luckily, this appointment turned out to be one of the most informative and reassuring I have had on my journey so far. At the end of the appointment, I was equipped with exercises to do at home and a potential reason why I developed prolapse in the first place. So if you are nervous about going to a physiotherapy appointment I just want to say don't be (easier said than done I know)! There are so many other options out there besides surgery. Physical therapy can offer long-term relief from your pelvic organ prolapse. So here is a little bit out my appointment and my top tips:
So things I learnt from my physiotherapy appointment about my prolapse 1. She suspects I have prolapse due to constipation as a child 2. I have perineal descent 3. I can have children but I may have to have a C section BUT I will have to speak to gynaecologists and specialists beforehand to find out what is best for me at that time !! 4. I can potentially reduce my prolapse symptoms 5. I shallow breath 6. I need to pee less (she suggested I do calf stretch whenever I needed to go or count backwards from 100)
A bit about the appointment: The initial part of the appointment was to talk about me and my condition. We talked through my journey with prolapse, my sex life, my toilet routine, what makes my prolapse worse etc. She then went on to do an internal examination to help her to determine whether I have a tight pelvic floor and the extent of my prolapse. I then had to do some breathing exercises whilst she felt my pelvic floor (yes internally) and then finally I tried to release and contract my pelvic floor. For those of you who have prolapse you are probably used to these internal examinations by now, however, this does not make them any less daunting. For me, they are always painful and uncomfortable. Here are some of the ways I try and relax during it - 1. Focus on a spot on the wall 2. Make sure I am breathing in and out 3. Reassure myself that this will help me in the long run
At the end of the appointment, she gave me some breathing exercises and stretches to do that would help me relax my pelvic floor. The two exercises were happy baby stretch and full squat stretch hold. She instructed me to do them twice a day for 30 seconds each. I also was instructed to do breathing exercises focusing on deep breathing. At my next appointment, she said we would focus on strengthening my pelvic floor as she thinks that is a key reason why I need to pee so often and why I have leakage when I laugh a lot. Also it is important to remember although these exercises were given to me that doesn't mean that they are the best thing for you!
So I went home equipped with these exercises and 4 weeks till my next appointment. Now being completely honest with all of you reading I have always struggled with finding the motivation to do my exercises. I know that they will potentially reverse my prolapse or at least make it less noticeable to me, yet I just cannot find the motivation to do them, especially when I have just finished a tough day a university. So here are some of the things I do to help motivate myself to do them:
Do them in the morning that way I will be less exhausted
Get a friend or relative to do them with you
Do them in front of the TV in the evening (although this can sometimes look at bit odd)
Don't allow yourself to watch TV until you do it
Think of the long term gains
Another thing that I have always feel anxious about is whether having prolapse will impact my ability to have children. Although I am not set on having children it is certainly not something I want to rule out at such an early stage of my life. So at the end of my appointment I asked her if she knew if you can have children with prolapse. The answer was: Yes you can. She has known people will even worse prolapse than me to have children. She said it is important that before I am pregnant I consult with professional gynaecologists and specialists to find what is best for me. She said it is likely I will have a C section however not definite. I have no idea how my prolapse will be even in a few years or even in ten years and so it is important not to worry about something that in a few years can change. At the moment I am trying to just focus on my exercises and physio and taking it day by day.
So, I realise this is only a short blog, but I hope that some of the tips I have given are useful and that it helps ease your nerves for your own physiotherapy appointment. From my appointment I learnt more about my condition and the potential cause of my prolapse. I also felt after in more control of my condition as I was equipped with exercises I could do when I got home. So if you are nervous about your first or even any of your physiotherapy appointments that's okay and that's normal ! But hopefully the appointment will help feel more empowered and restore your hope if you have had a bad experience with medical professionals. If you don't feel like the appointment helped or if you felt uncomfortable with the physiotherapist you had then that's okay too, there are lots of other physiotherapists out there willing to help you. It's important to find one that you feel comfortable and have a good relationship with.
Ps: here is a really good link I found: https://pogp.csp.org.uk/publications/pelvic-organ-prolapse-physiotherapy-guide-women
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