Alright brave readers, we’re about to talk about my vagina again. As mentioned in a post two months ago, I’m suffering from what is known as a pelvic organ prolapse. I’m sure some of you may recoil at reading those words, but it’s one of those shitty things that happens, frequently, and I’m not ashamed to talk about it. (Though not excited to admit it, it’s certainly not something I ever anticipated having to write about).
Pelvic organ prolapse (or POP) is incredibly common – 1 in 4 women will experience it during their lifetime. Yet we RARELY hear about it, because our vaginas are supposed to bring us shame or some other bullshit like that. Runners can carry on endlessly about the state of their illiotibial band or plantar faciitis, so as far as I’m concerned, this is another body part that affects my running, so it’s up for discussion.
ESPECIALLY because of those statistics.
ONE in FOUR women? That means, chances are, 25% of the women reading this have either suffered or will suffer from POP. And when/if they do, they, like I did, will desperately seek out others personal stories that reassure them that they are going to be OK. So, anyway..
After nearly two months, I finally got in to see the urogynecologist, a specialist in the world of pelvic organ prolapse. The physician I met with was incredibly professional, thorough, and most importantly, sympathetic. He listened, for a long time, and answered all of the questions I had to ask. He didn’t end our appointment until he was certain all of my questions and concerns were addressed. I’ve never had a doctor show such patience and compassion. No wonder it took so long to get in to see this guy.
(If you’re local, I’m happy to give a recommendation.)
My diagnosis was exactly what I expected and already knew: a bladder prolapse (cystole) through the anterior (front) wall of the vagina. The prescribed course of treatment, however, was not what I anticipated. Ultimately, the doctor let me know that a pelvic organ prolapse is considered a “quality of life” issue, not a “life or death” issue.
You see, with my hernias, there was always a chance of strangulation of the intestine, which is considered an emergency situation…and can potentially even lead to death. Thus, surgery was necessary to fix this bodily malfunction. Twice in my case, ugh.
But, when your bladder (or uterus, or rectum) prolapses through the muscle in your vaginal wall? Well…it sucks. It’s uncomfortable. It’s problematic at times. But it’s not going to kill you.
Thus, the physician left me with three options:
The “do nothing” option left me feeling equal parts deflated and optimistic. The doctor claimed that a moderate, reasonable (in real people terms, not ultra terms, *sigh*) amount of running would not make the prolapse any worse, and there is no research/literature available proving otherwise. This of course went against everything I’ve read in every (gloom and doom filled) online forum (though, no actual research was provided there either, just hearsay).
Alas, he’s the expert, not the internet keyboard warriors. So I’m cautiously trusting his word.
Admittedly, “doing nothing” almost feels like a “life is hard and these are the cards you drew, so suck it up” sentence. It feels unfair. An air of “why me?” sets in. Yet at the same time, it left me feeling somewhat positive: doc says I can run, and we’ll see how my body responds before moving on to options #2 and #3.
Get Fitted for a Pessary
A pessary is a prosthetic device of various shapes and sizes inserted into the vagina to reduce the protrusion of pelvic structures (in my case, the bladder) into the vagina. The idea is that this could be worn while running to reduce symptoms, such as discomfort or even urine leakage.
I have a follow up appointment in two months, where we will address this option.
The doctor took time to explain to me exactly what this surgical procedure would look like. It included a hysterectomy, tacking the bladder back up where it belongs, and rebuilding the muscular wall that has collapsed (among other things I don’t remember, because it was a lot of medical terminology I was unfamiliar with). This option requires a minimum of 3-4 months of recovery time. No running, no heavy lifting (more than 10 lbs), no sex, etc.
It also likely requires a lot of money, and I am currently uninsured. Welcome to America. So this option is currently off of the table for the time being, which is fine with me, as 4 months of recovery is a lot to commit to for something that is only moderately inhibiting at the moment.
Discomfort is relative, eh?
My biggest fear, of course, is that the prolapse WILL get worse. And it can potentially get much, much worse. I’m fortunate that my current level of discomfort is just that – discomfort. Other women experience pain, difficulty using the bathroom, and even prolapse of the bladder, uterus, and rectum…all at once. I can’t even wrap my mind around suffering from all three.
THINGS COULD BE SO MUCH WORSE.
So I left the doctors office with permission to run (in moderation), lift (in moderation) and get back into the habit of regular core and posture work, to help aid with pelvic floor health.
Old Habits, New Norms.
Of course, since a medical professional gave me permission to run, you know that night I went running. I wasn’t going to waste one more day not doing the thing I love so much.
I’m faced with the reality that for a while, I need to break old habits and be accepting of new norms in my life. I have to shut up that voice that is always saying “just a little further, just one more mile, just ten more minutes…” etc.
You see, in addition to this prolapse, I’ve managed to put on 15 lbs since late October, and my blood pressure has increased. What is typically around 110 / 70 is now 129/80. And while the nurse says “oh, that’s not bad!” I know that’s actually pre-hypertension.
And that scares the shit out of me.
Clearly, my body is not happy. Whether it was the events of pushing too hard the last few years, or something else (still to be determined, blood work and thyroid testing is next on my laundry list of doctors visits), I’ve got to start taking control of the things I CAN control.
And one of those things is practicing healthy moderation when it comes to my exercise.
There was a point, when I was training for the Georgia Death Race, that I felt a lot of pride in my hard work, even though I was absolutely exhausted. As many of you know, I’d go into the gym, put in an hour on the stair master, bust my ass teaching a HIIT group fitness class, lift for another 90 minutes, and finish of my day with a long run of ten miles or more. This was my normal routine (and truth be told, I was also in the early stages of grieving the loss of my Dad as well, and this is how I dealt with it), and continued even after the GDR bust.
I remember one day driving home from the trail with my family in the car. I was sitting a stoplight, waiting to go straight. I had a green light, and I was yelling at the guy on the other side of the road, with his blinker on to turn left. “WHY WON’T HE GO! HE HAS THE RIGHT OF WAY!” Geoff looked at me like I had two heads – I’m usually a very safe, very aware driver, and he knew I knew that I should have the right of way. He asked if I was OK.
I wasn’t OK. I was fucking exhausted. Perpetually. But I didn’t think anything of it. Because pushing to the point of nearly breaking is not only often normal it’s considered admirable in this realm.
Even if it might be contributing to your demise.
Listen, I’m not going to lecture about the potential risks of “doing too much”. Everyone’s body handles these things differently, and mine clearly didn’t handle the physical and emotional load of last year very well. And even though I saw the signs of it coming for a long time – I ignored them.
And now I’m paying for it.
I could “boo-hoo” about it…and believe me I have. It’s hard when your identity is wrapped up in not just something (running) but the extreme version of something (ultra running) and that is temporarily off of the table.
BUT, I’m choosing to focus on the positive. SOME running is better than NO running. A moderate prolapse of one pelvic organ is better than severe prolapse of three pelvic organs.
2020 for me is going to be about shorter distances, trying new things (just dropped my bike off at the shop for some alterations and a tune up, I guess things are getting a little more serious between us), and simply enjoying “doing”, at all, rather than feeling like I have to do it all.
It’s time to get healthy. Time for a reset.
So, to those of you who have reached out for an update – here’s your answer. Thanks for caring and for your endless support.