Archive for The Treatments

The first step to Wellness

Navigation of treatment is one of the many obstacles that an individual faces when dealing with trauma.  In both physical and emotional trauma, the simple confession, if you will, to oneself of one’s situation needs to be the very first step.  Admitting to yourself the need for help is one thing, but sharing your problem with another is often extremely difficult.  Unfortunately, when dealing with stigmatized trauma, such as mental illness and incontinence, the essential step of sharing one’s difficulty is often never mastered.  It may not be achieved for years.  However, once you are able to discuss your physical and emotional traumas with another human being, you have made a great leap into treatment.  Talking about your worries is crucial to treatment.  My treatment model followed the following path over the course of 3 + years:

1. Admit to myself that something was not “right” with my incontinence. Talk with my husband, Talk with my mother. See my OBGYN.-Unsatisfied with results. See a new OBGYN-Unsatisfied with results.  See another new OBGYN. Diagnosed with fecal incontinence. See a Gastroenterologist. Begin Physical Therapy.  See a Rectal Surgeon.  Have extensive testing on the sphincter.  Discover exact defect.  Enter specialized Physical Therapy.  Admit to myself that something was not “right” with my brain.  Talk with my husband.  See my OBGYN.  Get prescribed medication.  See Cognitive Behavior Psychologist.-Unsatisfied with results.  See EMDR specialist. Diagnosed with PTSD with related anxiety disorder.  See a Psychiatrist for medicine management in conjunction with EMDR psychotherapy.  Leave work due to PTSD, anxiety and incontinence. Rectal Surgeon prescribes new treatment for fecal incontinence.  Have Interstim therapy implanted. Discharged from Physical Therapy.  Discharged from Psychotherapy. Titrate off of medication.  Cleared to go back to work.

As you can see, for me, admitting WAS the first step on a journey that would take over three years to travel to wellness.  However, I continue on my wellness journey daily and to date it looks like this:

Start a blog, continue blogging, become a patient ambassador for Medtronic Interstim, become pregnant with second child, turn off Interstim implant, experience setbacks with incontinence and pelvic floor weakness, attend Physical Therapy, have second child, experience wellness with incontinence once Interstim turned back on, facilitate a local support group for bowel disorders, get a part time job.….be engaged daily with a life that seemed unimaginable in the immediate aftermath of trauma….

You can do it too.

Thanks for reading,

Lauren

 

 

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Automatic

When my PTSD was in full swing, I felt as if my life was on automatic.  Stumbling through the days in a zombie like fashion, I can recall the times between panic attacks as dull, scheduled, the same.  Keeping my routine while suffering with PTSD was very important to me.  Deviations from said routine were anxiety provoking, heart palpitating, sweat inducing experiences that I tried my best to avoid.

PTSD cannot turn on and off.  It’s always there, ready to pop out at any triggering moment.  I found it difficult to acquire new skills, capitalize on my old skills, and create new relationships.  I found it difficult to remember to fill my car with gas, drive new places, create a new recipe for dinner, make new friends, keep up with old friends, do housework, and many more.  In fact, I found it difficult to do anything but sit.  And even that was hard.  Sitting requires relaxing, and relaxing was something my mind could not do unless heavily medicated.

PTSD tears you apart, it tears your relationships apart, it knocks your skill level down, and it devastates your life.  It is not something you can have respite from.  It is something that is locked in your mind, waiting to pounce out when triggered.

Lots of family and friend support, and a competent EMDR therapist will help you emerge from the darkness of PTSD.  Time without therapy does nothing to cure  PTSD, in fact, it only makes it stronger.  Unless you want to be on automatic, with bouts of panic, I encourage you to seek the help you need.

Thanks for reading,

Lauren

“Till it’s gone…”

So many times I have heard the phrase used, “You don’t know what you got till it’s gone.”

This is especially true with trauma.  In my case, physically and emotionally.

Hindsight is 20/20.

If I could kiss my sphincter pre-trauma, I would.  Yes, I am suggesting that if you have the ability to go to the bathroom, if you don’t even have to think about it, then, kiss your ass.  Because, guess what, it does a GREAT job.  You don’t even have to tell it to do a good job.  You don’t even have to go to physical therapy, eat a modified diet, wear protective undergarments, consider surgery-because, it’s working for you.  And guess what-you don’t know what you got till it’s gone- so APPRECIATE it!

If I could kiss my brain pre-trauma, I would.  Yes, I am suggesting that if you don’t have any of your neural networks tied up in adrenaline laced triggers, if you don’t have confusion, agitation, blocked endorphin flow, then kiss your brain.  Because, guess what, it does a GREAT job.  You don’t even have to tell it to do a good job.  You don’t even have to go to endless hours of therapy-because, it’s working for you.  And guess what-you don’t know what you got till it’s gone- so APPRECIATE it!

So, that’s it.  I didn’t know what I had, until it wasn’t there anymore.  Even though the fall-out wasn’t fun, if you’re able to get something back-it’s a truly awesome feeling.  Although it will never be the same, I can modify the phrase by saying- “You don’t know what you got till it’s gone…but if you can get it back, the appreciation and joy you will feel is overwhelming.”

So, excuse me, I need to kiss my ass now.

Thanks for reading,

Lauren

A Runcible Spoon

“They dined on mince, and slices of quince, Which they ate with a runcible spoon,”

 The Owl & The Pussy-Cat by Edward Lear

“What the heck is a runcible spoon?”  This was the question I was asked by my 4 year old daughter.  Overlooking the word “heck” as her word of choice, I asked myself, “what the HECK is a runcible spoon?”

Luckily, a friend with a smart phone quickly cleared up the confusion….A runcible spoon is….nothing, it is made up, it is vernacular associated with the writings of Edward Lear, being first introduced in his famous story,  The Owl & The Pussy-Cat.

This got me to thinking…how many times throughout my medical journey with birth trauma do I listen to “runcible” spoon jargon? I’m not suggesting that the medical community is speaking a made up language, which it turns out a runcible spoon is, I am more talking about the times I say to myself…”What the HECK is a (enter runcible spoon medical vernacular here)?”

While wading through a trauma that is rarely talked about in mainstream conversation, I have had many “runcible spoon” moments.

Some of my “runcible spoon” moments:

Pudendal Nerve, EMDR, defocography, Interstim, anal wink, anorectal manometry, fistula, prolapse

To all the above terms, and many more, I asked “What the HECK is that???”  As an advocate, I urge you to clarify those “runcible spoon” moments in an effort to maximize your care and further your understanding.

Thanks for reading,

Lauren

Tears and Tears

Tears and Tears.  Words that sound the same, but mean very different things.  Tears (torn) and Tears (crying).  For me, there is a huge correlation between these two homophones.

When you have a baby vaginally, there is a risk that you will tear.  Recently, I came across a website that shows diagrams of vaginal tears in childbirth.  This slide show is an essential viewing point for anyone who wishes to understand visually the physical trauma of a tear.  Feel free to view here: http://www.mayoclinic.com/health/vaginal-tears/PR00143

Although vaginal tears are common during vaginal birth, the severity of the tear and the “how to” of the repair differ.  In her blog, Dr. Amy-The Skeptical OB, Dr. Amy Tuteur talks about the ability to midwives to repair tears during vaginal birth. You can read her take on tearing here http://skepticalob.blogspot.com/2012/02/vaginal-tears.html.

As a recipient of a third degree tear in a hospital setting, I am curious about the ability of my doctor to repair my tear during my forceps assisted vaginal birth.  According to the mayo clinic slide show, the repair for my tear should have been a bit more extensive and done with a little more care.  Maybe it should have even been done in an operating room rather than at the foot of my delivery bed.  http://www.mayoclinic.com/health/vaginal-tears/PR00143&slide=4

Tears often follow tearing.  For me, the physical pain of the initial tear as well as the physical and emotional consequences that follow such a trauma created lots of tears.  It is my hope that midwives and doctors understand the long-term ramifications of diagnosing and repairing a tear correctly.  My tear was not repaired correctly, nor was I given the postpartum support necessary for the tear I sustained.  Luckily, I managed, on my own, to get to a rectal surgeon, and ultimately, to Interstim, to treat the incontinence issues that began with my tear.

Thanks for reading,

Lauren

Vagina Monologues

“My Vagina, My Vagina, Me.”

This was the refrain that the audience engaged in throughout the show “The Vagina Monologues.”  An excellent, thought provoking, and barrier crashing endeavor, “The Vagina Monologues” strives to tear down the shame, stigma, and embarrassment surrounding violence against women. (and their vaginas)

It was probably about 8 years ago now since I sat in on this performance, but I can still remember the awkwardness of the word “vagina” coming out of my mouth.  Even more awkward, was listening to my boyfriend (now husband) saying over and over “my vagina, my vagina, me” throughout the show.

I’ve come a long way.  I can not only say vagina, I can talk about vaginas, blog about vaginas, and fight for vaginas!

MY VAGINA, MY VAGINA, ME!

Thanks for Reading,

Lauren

 

Story Toppers

About three times a week I attend a water aerobics class.  Because this class is during the day, I find the average age of the clientele in this class to be about 65.  (But, boy, these Grandmas can move!).  Because of the geriatric nature of my watery exercise regimen, I am often bombarded with the phrase “Oh, but you don’t have to worry about that, YET!” while engaged in a social discussion regarding “senior” medical matters prior to or post workout.

One of the favorite topics of discussion seems to be the colonoscopy.  Phrases and snippets addressed to me include: “So and so isn’t hear today, she’s preparing for her colonoscopy…you just wait till that…” “Ughh, I hate the prep work, you’re so lucky you’re young.”

Little do these ladies know, a colonoscopy is the least of my worries.  I think I could wow them all with the amount of enemas I have needed to do, the amount of “awake” rectal testing I’ve engaged in, and the fact that I lost my anal wink at age 27 due to the stress of childbirth.

But the story that tops them all, the story that makes a colonoscopy look like a trip to Disney World, is the defecography.  I never even knew a test like this existed.  To my great “delight” I had the necessary procedure when trying to determine the exact nature of my leaking sphincter. 

Step 1-Give yourself two enemas at home.

Step 2- Drink a glass of Barium (i.e. liquid sidewalk chalk) without promptly throwing it up

Step 3-Have a catheter placed to drain you of all urine

Step 4- Flip over, have a device that looks very similar to a caulk gun push a caulk like substance up your rectum

Step 5- Climb up a ladder onto a toilet bowl that is placed in the center of the room

Step 6-Try to relax while two people hold in place 2 x-ray plates around your body

Step 7-Poop out the substance (this is especially lovely with your audience)

Step 8- Enjoy the video recording of your bowel movement for years to come!

Top that, Grandma.  (Just kidding, I love Grandmas)  And, as unpleasant as this test was, it WAS necessary, helpful, and diagnostic.  It also gives me a story topper to whip out during my aqua aerobics class, but, maybe, I’ll just keep it to my blog.

Thanks for Reading,

Lauren

6 months

As of this past weekend, I have had my Interstim implant in for 6 months!  It is amazing how my life has been completely turned around for the last half a year.

The decision to have the implant was really a no-brainer.  I had exhausted the other “non-surgical” routes with little success.  The non-surgical routes of exercise, diet, and physical therapy are all components that serve to strengthen my Interstim now, but did little to appease the nerve function that I lacked prior to the implant.

Just for reference, the surgical route prior to Interstim was a scary prospect.  Before Interstim, my choice was to have my sphincter cut, then sewn back together tighter….repeat surgery every 5 years.  The prognosis of a successful surgery was limited, and there was a very real chance that more harm could be done.

With the sphincter cutting surgery as my only option, you can imagine my relief when my rectal surgeon recommended Interstim.  The surgery itself is low risk, and the prognosis of success is pretty high.  There was no hesitation for me to embark on this journey 6 months ago, and I cannot wait to see where it leads me!

Thanks for Reading,

Lauren

 

EMDR

EMDR are four letters that, for me, never were linked in a meaningful way prior to my trauma. EMDR (Eye Movement Desensitization and Reprocessing) is the therapy that helped me climb out my PTSD.  At the risk of botching up the “official” explanation, check it  out here: http://www.emdr.com/general-information/what-is-emdr.html  

EMDR, to me, was a true lifesaver. It is a well suited therapy for trauma in the way that it does not employ just “talking” about the problem.  “Talking” about the problem is a trigger.  Talking along with moving my eyes in well defined, therapist directed way, allows for desentization and reprocessing of the trauma, as well as the triggers that are ever present in PTSD.

Recently, I was discharged from EMDR therapy.  I had exhausted all my triggers, and worked through the trauma.  Does this mean my memory of the trauma is gone?  Not at all.  It means my memory of the trauma no longer creates a panic type response.  Successful completion of EMDR means I can talk about the trauma without falling to pieces.  Successful completion of EMDR means I can spread the word about a therapy that works wonders for those suffering with PTSD.

Thanks for Reading,

Lauren

Just Keep Swimming

One thing that I have found essential to my healing journey is exercise.  Exercise releases feel good endorphins, keeps my weight down, and allows me a great way to beat stress without medication.

Prior to my trauma, I thoroughly enjoyed swimming as exercise.  As a college level competitive swimmer, I was used to tough workouts and long hours in the pool.  As you can imagine, fecal incontinence and swimming laps in a pool DO NOT MIX.  In fact, there are signs posted everywhere that any fecal matter in the pool will result in a pool closure for all patrons.  Besides the obvious fact that a leakage would affect other’s enjoyment of the pool facility for the day; there was no way that I was getting into a pool if there was a chance that I could have an accident.  Obviously this proved a huge loss, emotionally and physically, as I thought about all of the times I would miss in the pool.

Through physical therapy, but, prior to my Interstim surgery, I gained some control of my bowels that would allow me a pretty good idea about when my leakages may occur.  It was at this time that I began to swim again, albeit cautiously.  Even though I felt good about going into the pool again, my plans could change in an instant if I was having a bad day with my sphincter.

Fast forward to now.  Interstim has allowed me complete freedom in the pool.  I no longer foster feeling of uncertainty and grief when stepping into the chlorinated goodness that was my second home prior to trauma.

It turns out that swimming is one of the best exercises I can do with my Interstim implant.  The low impact exercising has allowed me to stay in shape, engage in great workouts, and have fun again.  I could not have imagined this 6 months ago.

Thanks for Reading,

Lauren

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