41 weeks on, 41 weeks off… (9 month postpartum update)

This week Maura has officially been in the outside world as long as she was inside me. I’m

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On the left, I’d been having contractions for 12 hours, ready to go to the hospital and had NO idea it’d be another 13 hours until Maura made her appearance! On the right, “Hi!” from Maura and I. Cast and all, our combo weight is still less than what I weighted on the left, ha.

sure you’ve heard 9 months on, 9 months off referring to allowing yourself 9 months after baby is born to get back to your pre-pregnancy weight and feel like your old self, I gave myself an extra week or so since Maura did the same for herself on the inside, haha.

I’ve been eyeing my weight, but not focusing on dieting or losing it. I also had to take quite a lengthy break from formal exercise. I can finally say that I’m feeling pretty good! It took 3 different doctors and 7 months of physical therapy…. but I feel good. Maybe the 9 month wait has some truth to it after all. The one thing that all three doctors told me was that a woman is considered postpartum for a full year, not 6 weeks or 12 weeks but an entire year. This was so important for me to hear! There is so much pressure to jump back into a fitness routine and lose the baby weight immediately and I felt awful about myself that not only could I not start running again at 6 weeks, I could barely get through the day without feeling terrible.

Since my 6 month update, things have improved tremendously. At 6 months, I was feeling really frustrated with the lack of improvements to my pelvic floor and prolapse issues even with physical therapy. I was pretty much told there was nothing left for me to do, and I couldn’t except that. I ended up making an appointment with a specialist in urogynecology. (Basically a GYN who also has specialized training in pelvic floor organs, not just tissue). I was SO glad that I kept seeking answers because my appointment went great. Which is so weird to say, haha. My appointment was around 7 and a half months postpartum. The Dr. did the exam and immediately said that the prolapse was very minor. This confused me because I had been diagnosed with stage 2 bladder prolapse by two separate people… and I was still experiencing a lot of discomfort. She then explained that I had a ton of scarring and inflammation, making everything so sensitive that I was feeling symptoms from the level of prolapse that most women who have it don’t even know. She prescribed Estrogen and it’s been helping a lot. I won’t need it forever, and chances are once I stop breastfeeding my hormones will recover on their own and I’ll be able to put this behind me. She also sent me back to physical therapy after taking a month or so off because my pelvic floor muscles were extremely tight – we still aren’t sure why they became tight when they weren’t before – but I have a feeling it’s a combination of desperately attempting kegels (which I still can’t do). I also don’t know why the prolapse got better. The only thing I can think of is that I was slower to recover/heal than most due to the anemia and what takes most women 6 months, took me closer to 8. I debated not writing about this again… it’s so personal, yet if it helps one other person going through similar, I’ll risk it. Women’s health needs to be discussed, even if it does feel embarrassing. The message I want to drill into others is that you can and should get help. There are doctors out there who want to help you, you might have to see a few… but it’s worth it in the end. Don’t be embarrassed, don’t suck it up because you think it’s just part of having a baby, just go get yourself back to feeling good.

*If things had NOT gotten better on their own – for anyone who is looking for a story with a different ending – the specialist said that there are hundreds of types of pessaries, and that she often sets up whole afternoons for women to do fittings – and try and try until one works for them. Other Drs who don’t specialize in this may let you try one or two, but a specialist has more available. She also said that unless symptoms are severe, they do not recommend surgery for younger women (meaning non menopausal). My other tip is do not google. Google had me in tears almost every night until I got things figured out, just stop searching for answers on your own and see someone who is trained to help.*

The past 9 months (closer to 10) have been about getting my health back, the next 3ish months are going to be about getting my fitness back.

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Six Month Postpartum Update

The past six months have been incredible in so many ways, and awful in so many others. Incredible in every aspect related to the amazing little human I now have in my life, but my recovery isn’t what I expected. I am no where close to where I thought I would be at six months postpartum. Heck, I’m not even where I thought I would have been six weeks postpartum!!! If anyone needs the back story, you can find it here. Be warned that there might be a little TMI involved in both the back story and below….

If you don’t want to read about postpartum issues – feel free to stop reading now. You’ve been warned.

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Whenever I feel down, I look at this face and can’t feel anything but happiness.

I’ve actually been dreading this six month mark. I was told at the beginning of PT that 70% of mild/moderate postpartum prolapses are either gone or no longer symptomatic at 6 months. When I was told this I remember thinking ‘How can I handle feeling like this for 6 months!?’ but now it’s 6 months, and I’m still symptomatic. I’m not in that 70%. What happens to the other 30%? Will I feel like this forever? I don’t think so…. I have improved, but I just haven’t gotten to a point that I’m happy with. I can’t run comfortably, I can’t lift heavy, and I often just feel crappy by the end of the day. I also admit that I really let this get to me often and feel pretty alone and isolated – which is my motivation to share some of my story – if anyone else feels alone in it too. It’s apparently common, but no one talks about it…

I have progressed significantly with my PT exercises. As I said before, there are many muscle groups effecting the pelvic floor and I have increased my strength in all off them…. except my kegel strength. One a scale of 0-5 (0 being that you cannot contract the kegel muscles at all) I started PT at 7 weeks pp at a 1. At that time, my PT was impressed because many women with delivery injuries are a 0. Unfortunately, at 4 months I was still a 1…. maybe a 1.5… but definitely not a 2 yet. I was extremely discouraged, and my PT was surprised given the amount of strength I had increased elsewhere – I was clearly doing my exercises. We began to suspect nerve damage from delivery that wasn’t allowing me to send signals to an area of my pelvic floor.

We discussed a few options. One was the use of a pessary. A pessary is a device that you can put in and take out on your own and it supports the prolapsed organs to relieve symptoms. It would allow me to run and lift and get back into my old routine. I went and got fitted by my OB. When I was at the office, it felt great and I was really hopeful. I planned on only using it during workouts, and did a few times but I don’t feel like it fits correctly. I’m in the process of getting another appointment to see what other shapes there are, if there is another that would work better for me. I find this one painful to get in and out, and I feel irritated after wearing it…. blah. I really had my hopes up for this. Second was the use of estim. I’ve heard of estim for other muscles, but for vaginal muscles…. eek. Estim sends an electrical impulse through the muscle contracting it. Sometimes it can help the muscle memory and bring back your ability to contract the muscle on your own. Being desperate I said let’s do it. I borrowed a machine from the PT office and was instructed to use it a minimum of 3 times a week for a month. That would be the minimum frequency that would show any improvement. I hate it. It’s kind of painful. But, I’m determined. I’m crossing my fingers and hoping this helps. If it does…. it will be a few more months to get those kegel muscles up to strength. My other chance is that when I stop breastfeeding, estrogen levels may help to firm things up and reduce symptoms also. I don’t have intentions of weaning anytime soon though…

Postpartum other than prolapse…. is not bad. My hair has been falling out since month 4, but I think it’s slowing down. I’m still up about 8 pounds, but am giving myself until New Years to lose that…. 9 months on, 9 months off right? My energy feels pretty good – I’m tired, but not sick-tired like I used to feel.

Progress is being made, slowly. I find it really difficult to watch other new moms bounce back into their old routines. I’m jealous. I shared my story with my Mom class (they asked who was willing to share birth stories), and although sympathetic – my instructor said “But it was worth it right?” and Yes… it was. If you told me this would happen prior to having Maura, I wouldn’t have done anything differently. I couldn’t imagine my life without her. But just because it’s worth it, doesn’t mean it’s fair. Why did I have to pay a bigger price? Life isn’t fair though and there’s got to be a silver lining. I’m just still looking for it.

I’ll keep you posted. Not because I really want to share super personal information on the internet, but because when I looked for stories I found a lot of menopausal women’s stories, and stories that ended before 6 months. I want women to know this is a possibility, but also something to hopefully overcome.

A week of exercise (8/28-9/3)…

Last week was the first full week since I officially started running again. I’m tempted to say I started “running” again…. but I should give myself some more credit. I ran – slow – but I ran. I figured I’d try and keep track of what my early weeks look like getting back into a routine. Thus far – it’s run when I feel like it and it’s convenient. The other days we walk. Don’t underestimate the power of a good walk! I was unable to run for quite a long time, but I think walking almost every day makes the transition back to running that much easier (even though it’s never easy after much time off).

My week:

Sun – 5 minutes walk, 20 minutes run, 30 minutes walk (This was my 3rd run back… the first two were 15/16 minutes each)

Mon – 55 minutes of slow walking with the stroller

Tues – I honestly have no idea…. I think I must have strolled a slow walk somewhere in the day – maybe 30ish minutes? My mom brain really has no clue…. how scary!

Wed – 5 minutes walk, 30 minutes run, 25 minutes walk (This was a whole family run! My husband had the dog, I pushed Maura… she LOVED watching the dog run alongside her and giggled constantly at him… motivation to keep going!)

Thurs – 30 minute slow walk with Maura in the carrier while she resisted nap time… the second half was quicker than the first because she ended up screaming until we were in the driveway returning home. She then fell asleep for 5 minutes only to wake up once I tried to move her to her crib… :sigh:

Fri – Nada….My husband took both ‘kids’ out for a run while I stayed home and tried to get a little work done in peace.

Sat – Hour long walk

The week doesn’t look like much, but it’s something. Seeing it in writing helps keep me accountable. I also realize that my PT exercises have become more sparatic – I think I’m just frustrated. Doing them has been reminding me of how slow going recovery has been. This coming week I’ll try to keep track of when I do those as well. I’m not helping myself by skipping them!

It’s only the beginning but I’m able to see the light at the end of this lack of fitness tunnel. I cannot wait until we can take long hikes and trail runs with Maura and introduce her to our love of being active and out there.

Why I like breastfeeding…

Every book I read about pregnancy and caring for newborns include a large portion dedicated to breastfeeding. A lot of sources are heavy on pro-breast or “breast is best” and I don’t want to add to the guilt many moms end up feeling if they aren’t able to breastfeed for whatever reason. However, I do know that a lot of women want to keep breastfeeding and are physically able but end up stopping due to various reasons.

I dreaded every feeding at the beginning.  It hurt. We struggled. Our first LC thought Maura had a posterior tongue tie that caused her latch to be shallow and therefore cause significant damage to my nipples. The second LC watched her eat and determined that she’s actually just an aggressive eater! She gets so eager to eat that her latch was just terrible. After some practice (and nipple shields while I healed up), we got the hang of it and things turned around. Maura still feeds on average every 2 hours throughout the day and has since she was born. Maybe this is why I’ve had to look for the positives – if we start a feeding every two hours and some feedings last almost an hour … that’s a lot of time spent with a baby on the boob.

So for those new moms who want to keep breastfeeding but need a little help wrapping their mind around keeping at it long term…. Here’s the list I came up with about why I like breast feeding:

  • It quiets my crying baby and brings instant peace (once she’s latched – sometimes it takes a minute or two)
  • It’s a forced time-out from the hustle of the day.
  • I don’t have to do anything else.
  • I get to soak in how small my baby is and just look at her.
  • If I want to get out of a situation – I can go nurse, and no one will question it (think too many visitors? or people staying a little longer than welcome…)
  • I can meditate or just zone out.
  • I can plan things out – meal plans, daily schedule, etc.
  • I can check my phone, social media, text, and even chat on the phone without distraction or feeling bad for not paying complete attention.
  • It’s me time as well as our time together.

And also remember that it gets easier. Feeds get shorter, frequency decreases. She’s only little for so long and breastfeeding gives me the chance to soak her in just a little bit more each day.

Why I’m seeing a Pelvic Floor Specialist…

Disclaimer – postpartum isn’t pretty. If you’re squeamish about lady parts, no need to keep reading…

As a pregnant woman everyone reminds you to ‘do your kegels.’ I was told the more I did that the easier delivery would be and the faster recovery would be. But was this kegel advice alone beneficial? In my case – no, and in hearing from other women, I’m not alone. The idea is that kegels help strengthen the pelvic floor muscles, and a strong pelvic floor can prevent incontinence, lower back/hip pain, pelvic pain, pelvic pressure, prolapse, etc. (The facts are out there and I don’t think I need to restate them). But the fact I do want to state, is that kegels during pregnancy are not a miracle prevention or ‘cure all’ for the pelvic floor. Even the strongest muscles can stretch and tear causing postpartum issues for those who thought they were physically well prepared.

I’ve been seeing a Pelvic Floor Specialist for physical therapy since 7 weeks postpartum. I began feeling a lot of pressure ‘down there’ about two weeks postpartum. I had a lot of damage that was healing but when things started feeling better, I realized the pressure hadn’t gone away but gotten worse. I went to my 6 week postpartum appointment with my OB and I expressed my concerns that I may have some type of prolapse, but she told me that she didn’t see anything ‘unordinary for this soon postpartum.’ I was told to come back in 3 months if things didn’t improve…. There was no way I was going to wait and see for 3 months before doing anything to help myself…. so I immediately called and scheduled an appointment with a pelvic floor specialist for postpartum rehab physical therapy.

My first PT appointment was awkward, but I left feeling so reassured. First the PT confirmed my suspicions and diagnosed a grade 2 bladder prolapse. She said that often times an OB won’t diagnose mild/moderate prolapse because they often heal themselves and are fairly common after childbirth – especially after difficult deliveries such as my own. However…. just because something is common does not mean it should be brushed off. There are things you can do in the meantime to help the healing process and we would be working on that together. She also assessed my kegel strength for a baseline measurement and I learned that I hadn’t even been doing them correctly before! (And apparently I’m not alone – many women come in doing them incorrectly because they’ve only been told how to do them and not shown.) Next she assessed the muscle tone of the vaginal wall (yes, awkward), however she identified several tight muscles that were preventing me from doing a kegel properly.(Just like if your quads are tight, your squats aren’t going to be as beneficial, same goes for pelvic floor muscles).

We developed a game plan of exercises, not just to help my prolapse, but as a postpartum rehabilitation program. She also assessed me for diastasis recti (abdominal separation common after pregnancy) and checked my sacroiliac (SI) joint since I had so much pelvic pain during pregnancy. I don’t have diastasis recti, but I do still have laxity in my SI joint due to the hormone Relaxin. The joint will most likely tighten when I stop breastfeeding and the Relaxin in my body decreases – in the meantime, we are working on strengthening the muscles around that joint to increase stability and to recover my core strength.

PT hasn’t cured my prolapse yet. I hear it’s a long road ahead, but having it assessed by a specialist and creating a game plan makes me feel better. I’m on the right path to recovering, and I have the guidance I need not to make it worse. Even without symptoms of prolapse – I highly recommend PT after childbirth. The body has gone through so much, and PT has been a way to understand how pregnancy and childbirth have effected my body specifically and how I need to take care of it.