I’ve always dreamed of becoming a ballerina. When I was little, I would invent twirly dances that my infinitely patient parents would sit through time and again, clapping enthusiastically at each dramatic leap. Two of my older cousins took ballet, and often sent us pictures of their performances. My enraptured face apparently did the trick, as,to my utter delight, their old tutus and costumes began arriving by the box load. Even now, I am glued to the TV each Christmas when The Nutcracker comes on, aching with envy at the gracefulness and beauty of the dancers. When it comes to grace and poise,I’ve always been much more of a Bella Swan than a Clara. Lately, though, I’d been feeling much closer to my inner ballerina, after having lost over 30 pounds -until, that is, I was diagnosed with pelvic organ prolapse.
It’s funny. We women will talk openly and freely about our periods, PMS, and menopause. We’ll share intimate details about our sex lives, and compare notes on pregnancy and childbirth. To help other women, we’ll not only talk about breast cancer and everything that goes along with it – we’ll shout it from the rooftops! And yet, when it comes to pelvic organ prolapse, a condition that, according to WebMD, will affect 1 in 3 women at some point in their lives, we are silent. Oh sure, we all get the same advice: “Do Kegels to strengthen your pelvic floor.” But if I had known that my bladder and my uterus would start falling out at age 32 – if I had known that was even a possibility! – I would have become a veritable Kegel queen, with pelvic floor muscles of steel! As it was, I thought I had plenty of time until that really became necessary.
I had, however, recently morphed into something of an aerobics fanatic. After having lost about 20 pounds by dieting and beginning a new walking regimen, I had decided to join a gym and dedicate myself wholeheartedly to working out, to reach my total weight loss goal of 70 pounds more quickly. Completely unexpectedly, I had fallen in love with the place – the treadmills and elliptical machines, which used to seem to me like instruments of torture, were now my good friends, and the weight training equipment was the sumptuous dessert to my cardio feast. I even joined a hip-hop aerobic dance class, which I attended religiously, despite my painfully embarrassing inability to mirror the instructor’s daunting moves. Simply by virtue of my weight loss and the fact that I was in a dance class at all, I was starting to feel light and graceful – even young again.
Then, one Saturday morning, I suddenly felt that something wasn’t quite right.Upon checking myself, I found that something – some sort of soft but firm tissue – was bulging down into my birth canal! I tried pushing it upwards, and to my horror, it yielded, disappearing up into my pelvis somewhere. The bathroom spun, and my legs began to shake uncontrollably. What was wrong with me?
Because it was the weekend, I couldn’t immediately call a doctor, and since there was no blood or pain, I didn’t feel it warranted an expensive trip to the emergency room. My first thought was uterine prolapse, which I vaguely remembered reading about when I was pregnant – but that condition had always remained, in my mind, in the shadowy realm of nightmare pregnancy scenarios, which I had escaped and passed out of danger from with the delivery of my children. I didn’t know if it was even possible for a woman who was not pregnant to suffer a prolapse, but my horrifying symptom seemed to correspond with the description I remembered. I spent the weekend paralyzed – figuratively and literally – with fear. I was terrified even to move for fear whatever it was would fall out of me completely.
First thing Monday morning, I made an appointment with an OB/GYN and drove, in a panicked swirl of thoughts, to her office. Once there, I was examined first by one of the doctor’s students. She told me that she didn’t see any prolapse, and thought it might be some sort of infection that had made me feel a difference. I was somewhat relieved, but felt foolish – was I really so unfamiliar with my own body that I had mistaken something relatively normal for such a frightening condition? When the doctor herself came in, however, she asked me to bear down as she examined me – and pronounced that I did indeed have a prolapsed uterus – and not only that, but a prolapsed bladder as well, which was in even worse shape than my uterus! She proceeded to give me my options: surgery to secure the organs back into place; a hysterectomy; the use of a pessary, which is something like a big rubber tampon that holds the organs in place; or – nothing. If I did nothing, life sounded pretty grim – no heavy lifting (including weights, grocery bags, toy boxes, children – basically,everything that a mom needs to lift in the course of each day), no vigorous or high-impact exercise (there went my hip-hop dance class –and all my weight loss plans, for that matter!), and nothing that would put any strain on my abs or core, because that could cause my uterus to pop right out! I was suddenly helpless, but in such a strange way. Not being visibly handicapped, I reflected that I would feel ridiculous asking for help in lifting or carrying things. Wanting so badly to lose my excess weight, I felt trapped in this body that was suddenly so fragile.
Surgery was just not an option for me, for many reasons. Our insurance would not kick in until we had met a $5000 deductible, so we would have to pay for it ourselves,which my husband and I, both teachers, simply would never be able to afford. A hysterectomy was out of the question, because we wanted more children. For that same reason, surgery to fasten my organs back into place would have been a waste of time – a pregnancy and delivery would destroy any repair work, the doctor told me,and any subsequent surgeries would never be as effective as the first. Even a pessary,the non-surgical option, didn’t sound satisfactory – they could cause lesions and infections in places I definitely did not want lesions and infections! I decided to get a second opinion.
The next doctor I saw confirmed the diagnosis, adding that my uterine prolapse was mild, while my bladder prolapse, or cystocele, was moderate. She actually examined me standing up, in order to allow gravity to do its worst to me. Her advice was, in some ways, similar – a hysterectomy, repair surgery, a pessary, or nothing – but in other ways, ways more important to me, completely opposite. She told me my only hope was to work out more vigorously than ever before, focusing specifically on my abs and core, to strengthen the muscles supporting my pelvic organs. This was exactly what I had wanted to hear, and yet, now that I had received two such opposing opinions, I was unsure. I wanted desperately to return blithely to my normal life,assuming my normal activities without giving any further thought to my pelvic organs,but, to put it mildly, I was still terrified. What if my uterus did just pop out one day, in the middle of my dance class? I decided to seek out one more doctor, to break the tie.
This time, I asked a friend of mine, whose brother was an OB/GYN, if she would run my situation by him and tell me what he thought I should do. She kindly obliged, and in just a few hours, she had emailed me his advice. No heavy lifting and no vigorous exercise; Kegels to strengthen my pelvic floor, and once it was stronger, then and only then could I try some upside-down sit-ups, to strengthen my abs while taking advantage of gravity to keep my pelvic organs from popping out. Great. The tie was broken, but definitely not in the way I had hoped for.
I honestly had no idea what to do. I was petrified of exercise, but every fiber of my being longed to get back to my routine. I was so depressed that I was eating everything I could lay my hands on, and I couldn’t focus on my job or family. I felt disgusting – overweight and literally falling apart. The 30 pounds I had lost meant nothing to me now – I, who had just begun to feel so lithe and almost graceful, now felt old and repulsive. I had already searched online for information on pelvic organ prolapse, and had simply found the same options the doctors had given me, over andover again. And again and again, online articles informed me that pelvic organ prolapse was a taboo topic that women did not discuss. It was too horrifying and disgusting – women were too embarrassed to admit to anyone that they had something hanging down into their birth canal, so they usually quietly underwent surgery, or simply suffered in silence. Finally, one day, it occurred to me to type in “uterine prolapse success stories.” That led me to a message board where someone had left this as their sole comment: www.wholewoman.com. That single post changed my life.
I devoured this new website as if starving – articles, personal success stories, advice – all related to pelvic organ prolapse. The woman who had created this wealth of information was Christine Kent, an RN and former ballet dancer who had herself been diagnosed with a prolapse, and who had spent years developing a program of exercises, lifestyle changes, and even postural changes to help stop and even reverse the progression of pelvic organ prolapse. Her philosophy, backed up by her medical knowledge and experience, seemed more reasonable than any of the doctors I had sought out. Try to remain, at all times, in a posture that supports your pelvic organs, rather than forcing them into positions that compromise their stability. Exercise regularly – not your lower abs, which could very well cause a worsening of your prolapse, but your upper abs, thighs, and buttocks, which can then help support your organs. And share your experiences with other women, in order to encourage and support one another through this difficult period in our lives. At first, I admit, I was still a bit skeptical. How was this woman any different from the doctors? But as I browsed her site, I found page after page of success stories – women gushing thanks at finding their prolapses reversed, women raving about Christine’s book and exercise DVD,women sharing the hope and joy they had found through Christine’s program. I had to try it, too.
When the book arrived, I read it cover to cover. I felt like I was back in high school biology again, but this time it was vital that I absorb as much as I could. EverythingChristine said made so much sense, and I couldn’t wait to start her posture and exercise program. As I digested her book, I began to frequent her website’s message boards more and more often. Far from being a taboo, here prolapse was the main topic of conversation – and what a blessed relief it seemed to everyone! The women on her site, including Christine herself, do what women everywhere do best – band together and offer support when things get tough. My family and friends were extremely supportive of me when I discovered my prolapse, but I honestly believe that if I had not happened upon WholeWoman.com, I would still be caught in the throes of indecision,fear, and depression. Those of us who have this condition, or know someone who does, have a responsibility to talk about it, to share information and resources, and to support each other, disregarding any silly label of taboo it may still carry. Breast cancer was once taboo, as well, and look what opening up has done to further research in that area! The millions of women who have a prolapse deserve to know that they are not alone, and do not need to suffer in silence.
When I put Christine’s DVD on for the first time, it was just to watch it through once, to see how long it would take and what equipment, if any, I would need. After just a few minutes of watching, I was crying. My journey had led me through the trials and joy of weight loss, through the fear and revulsion of prolapse, and now, finally, to the hope that life could be better than ever before, that I could be as graceful and feminine as I had always dreamed. On the screen before me, from her Whole Woman studio in New Mexico, Christine Kent was teaching me ballet.
I wake up every morning now at 5 am to practice pliés and tendus with Christine.Since starting her program, I have noticed a significant improvement in my prolapse symptoms. Under her tutelage, I have been able to resume most of my previous exercises, including weight training – the key to safety is the proper posture. I continue to lose weight, and feel that, in many ways, my prolapse is more of a blessing than a curse. It has made me more aware of my own body, more grateful than I ever thought possible for the support of others, more willing to reach out my own hand to help, and maybe more than any of these, it has helped me to fulfill a lifelong dream. I am a wife, a mother, a teacher, and a writer. I have a prolapsed uterus and bladder. And you know what else? I am a ballerina.
Angela von Weber-Hahnsberg is a school teacher in the Dallas, TX area.
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