Monday, April 30, 2018

Postpartum Pelvic Physical Therapy stopped my insides from falling out after my last baby



My postpartum recovery from diastasis recti, weakened pelvic floor and prolapsed bladder after my last baby using pelvic rehab therapy

I am not a medical professional, this is my personal postpartum recovery journey, please consult your doctor before beginning any type of treatment plan. This is not a paid or sponsored post, I genuinely had a fantastic experience with Dr. Le and Sport and Spine Rehab and physical therapy worked to resolve my postpartum issues. 

My postpartum recovery from baby number 9 has been my hardest to date; mentally, physically and emotionally.

I have had 9 kids in 13 years, my last 5 in 6 years and my last 2 babies were 11 months apart. I recovered quickly after all of my deliveries. Let’s be honest, I have had a good run. I could tell that something wasn’t right after my 9th baby was born in July. I was feeling vaginal/pelvic pressure, like I was still pregnant and felt like I needed to pee ALL THE TIME. I chalked it up to having a lot of kids and figured that it would get better, it didn't. For my birthday in September, my best friend who is a personal trainer, treated me to a training session. I was about 10 weeks postpartum at the time. I had been much slower to work out after this last baby, things just didn’t feel right. While I was working out with my friend, she had me do some body weight squats and I felt like my insides were falling out from pressure. When I did planks she asked me to tighten my core and I literally was trying so hard and couldn’t tighten anything. My abdomen muscles were jello.

I had my post delivery appointment with my midwife, Amanda, that next week. I told her how I was feeling and then after the exam she told me that I had a severely weakened pelvic floor, a prolapsed bladder and level 3 diastasis recti. It made total sense with how I had been feeling, but now what? I had never had any recovery issues in the past. I had heard of all those terms but had to look them up after my appointment. Postpartum diastasis recti is when the abdominal muscles separate during pregnancy. Pregnancy and childbirth can weaken the muscles and connective tissue in the pelvic area. A prolapsed bladder is when the vaginal wall is too weak to hold up the bladder and it droops down into the vagina. I kept asking Amanda, this is going to get better right, RIGHT? She never said yes, just we’ll see. I had a neighbor that had to have surgery on her prolapsed bladder and it was a rough recovery, she couldn’t lift anything for weeks. I have 3 kids 2 years and under, how would that work. My midwife suggested that I try physical therapy first. I got the referral and called right away. Anyone that knows me, knows I am horrible about self care, with 9 kids, my needs are last. But this time I called right away, I was feeling miserable and really wanted to try the physical therapy route to see if I could avoid surgery.

The physical therapy place, Sport and Spine Rehab - Chiropractic and Physical Therapy Clinic, was close by and I was able to get in quickly. I really had no idea what type of exercises I would be doing, I was definitely nervous. First I met with Dr. Tiffanie Le, she was fabulous and outlined that I would be working on strenthing my core muscles in the hopes that by strengthing my pelvic floor, it would pull everything back up again, in particular my bladder. That first session I was a little self conscious, but quickly shed that. For the diastasis recti they taught me how to roll to my side then use my arms to push up versus doing a sit up, which was ugly for me anyway right now. Then they proceeded to take me through a series of core strenthing and breathing exercises. They would have me start with a warm up, like the Bruegger Postural Relief then work on the core exercises.


Pictured below are the foundation exercises and each week the physical therapist would build on them.

Bruggers Postural Relief
Belly Breathing
Pelvic Tilts
    
Dead Bug
Modified Bird Dog


Glute Bridge

With 9 kids and a husband that travels I was only able to make it to therapy 2 x a week. Most of the exercises I was able to do at home, which I tried to do several times a week. Sport and Spine Rehab had great hours including evening hours and they were also very accommodating and let me bring my new baby with me to appointments. Those first few weeks the exercises were really challenging. I am an active person, but the concentration that it took me to tighten my core and squeeze my pelvic floor muscles was intense. I would leave sweating. 5 weeks into physical therapy I started to feel a change. My frequency/urgency to pee was less, the pelvic pressure I was feeling was less. My core muscles were weak but I could feel them start to tighten.

I continued my sessions 1-2 x a week for the next 4 weeks. I was feeling so much better. I had a follow up appointment with my midwife in December. I was really hoping that how I was feeling would translate into a good internal exam. I was holding my breath literally and figuratively during the exam. The physical therapy had worked! My bladder was no longer prolapsed, my pelvic wall was much stronger and my diastsis recti had gone from a 3 finger separation to a 1! Woohoo! I was estatic! If things had not worked out and I was told I would need surgery we would have figured out a way to make it work, but I was so excited to not have to go down that path.

The next day I had an appointment with Dr. Le and her staff, I had graduated from their program. They walked me through some more advanced core exercises that I could do on my own. I truly liked everyone that I had worked with there. They were all kind, proffessional and encouraging. They all gave me hugs as I walked out.

I am continuing to do the core exercises a couple of times a week and will do that for the forseeable future. My core strength is still not where I would like it to be, but I am working on making it stronger every week. My prolapsed bladder issues have been resolved and I can make it through a hard workout without feeling I needed to use the bathroom 10 times.

Here is my takeaway:
  • All of these pregnancy/postpartum complications I experienced can happen whether it is your first or ninth baby. My guess is that I had all of these issues after my seventh and eighth babies but since I was pregnant again so quickly they were not caught. 
  • I saw plenty of pregnant women at Sport and Spine Rehab strengthing their core. I wish I would have done that. 
  • I think that most moms would benefit from pelvic floor/core strengthening even without an official diagnosis.
  • I am so grateful that my midwife suggested physical therepy first versus surgery first. 
  • I also should have been more timely with my post delivery 6 week check up, by the time I was seen I was 10-11 weeks postpartum. 

Here are some tips that Dr. Le and I talked about for other mommas facing these postpartum issues. 
  1. If your OB recommends physical therapy make sure that you look for a Chiropractic/Physical Therapy place that is comfortable and knowledgeable working with postpartum moms. 
  2. You will want a program that emphasizes building back up the core muscles through core muscle exercises, breathing training, and postural training. All 3 will work to re-engage the pelvic floor. Make sure that you ask questions about the purpose of the program and exercises that you are put on. You want to make sure they are solving for what you need strengthened. 
  3. Do not be discouraged by this diagnosis, it will take time and hard work to heal 
  4. Slowing things down in the postpartum period will help you return to your desired level of activity with less risk of injury. During this time your body relearns to engage proper muscles to help you move better when you do return to your sport/activity. 
  5. Once you are on a program be compliant and consistent so you can get results.
  6. Keep in mind that not every pregnancy and birth is the same and the amount of activity prior to and during the pregnancy affects recovery.
  7. All mommas, prenatal and postpartum, can benefit from core training and exercise, you don't need to wait to be diagnosed with a condition or have pain to start rehab and therapy for your core and pelvic floor.
Dr. Le has her Doctor of Chiropractic degree from New York Chiropractic College. She is also:
- Webster certified (a chiropractic technique commonly used with pregnant patients; website for more info can be found here: https://icpa4kids.com/training/webster-certification/webster-technique/ ) 
- attended the Birthfit Professional Seminar (https://birthfit.com/
- in the process of acquiring her birth doula certification through DONA International (https://www.dona.org/)

Wednesday, April 11, 2018

Listen to the Children




I took my oldest two daughters, age 13 and 12 years old, to the March for our Lives in Washington DC on Saturday, March 24th. It was an amazingly powerful event for all three of us. There hasn’t been a day since that I haven’t thought about the students that spoke and their powerful stories and words. Every time I sat down to edit this post I got emotional thinking about that day.

This is not a political post this is a human post. I am not a vocal person politically. I have never gone to a rally, march or protest before this March. I am ashamed to say that unless it is happening at my kitchen table I may not know it is going on. These shootings that have become common place are affecting all of our families. Gun violence does not discriminate based on political parties it affects us all. After each of the school shootings I have felt so helpless to make a difference and to voice my request for change. Our hearts have broken with each life that has been lost. As a mother I want to protect my children and all children. Every victim of gun violence is someone's baby. After the Parkland shootings I cried and felt outrage, but I still didn’t know how I could help. As soon as I heard about the March I wanted to go, but with 9 kids nothing is easy. I was on the fence about it till the day before, I talked with my husband and he said I really want you three to go, we’ll figure out the logistics. Both of us feel really strongly about protecting all lives with more common sense gun laws. My oldest daughter was really excited we were going. She had participated in two student led walk outs at her secondary school in remembrance of the Parkland students. She immediately set to work making beautiful posters and ribbons for us to wear. My 11 year old was a little quieter about it. She asked lots of questions about logistics and how big the crowds would be and if we would be safe. That right there is their two personalities in a nutshell. 

There was a group of students and parents going from my daughter’s school that we had planned to meet up with. We got up bright and early and headed to the closest Metro station. At the station we were greeted by a group of students all carrying posters and wearing orange. You could feel the excitement and purpose in the group. Once we arrived in DC our group walked to the National Mall and to a meeting point. We met up with other local schools and we were greeted by our local representatives who talked to the students about the change they hope to see happen with gun laws. 

We then found our space in the crowd and waited for the March to start. It was overwhelming how many people were there - students, families, all races and ages. It was a beautiful sight. We spent all morning just looking at all the different signs and shirts.

Once the program started we were all mesmerized. Each student that spoke was so awesome and powerful. Topics that I stumble and stutter over they spoke so eloquently and full of passion. Their stories were heartbreaking. We were standing next to several families from Florida. They were in the same school district as MSD and had cancelled their spring break plans so they could attend. Two girls in front of us were recent graduates from MSD. They knew these students speaking, they knew their families. We all cried together, cheered together and sang together. The pleas and cries for change from the students and the crowd, makes me hopeful that change will come. When the March was done, everyone respectfully filed out together. As we were leaving a person started the chant, “tell me what democracy looks like” and the answer back was, “this is what democracy looks like”. There were almost a million people at the March all peacefully coming together asking for a change.




I asked my daughters and several friends that attended the March in DC and in New York to share their thoughts from that day.


"The March was empowering and inspirational. All the students that spoke were amazing but the three that really spoke to me were Edna Chavez, Emma Gonzalez and Yolanda Renee King. Edna Chavez's speech showed me that gun violence is not a new problem. Yolanda Renee King's speech showed me that that youth of our country are stepping up to change things. Our generation is going to be a great generation."           KB, age 12

"The energy is what made the environment boom, vibrant signs and people shouting made Pennsylvania Avenue light up. We were all there for the same reason, and for that it felt as if we were gathering with family. There were people from all over the country flying and driving in to make their voices heard. The most heart stopping moment was when D'Angelo McDade asked everyone who has been impacted by gun violence to raise their hands. Hands all around me were raised high. I am lucky enough to not have any encounters with guns or gun violence. The March made me realize how privileged I am."   

                                                                                                            SB, age 13

“Immediately after the shooting on February 14th at Marjory Douglas High School, the Parkland high school students took America by storm. As soon as I heard that they were organizing the March for Our Lives I knew I had to attend. Luckily, a generous network of alumni organized two buses to make the treck down from my school in Vermont. After spending weeks leading up to the March as a student leader in the efforts towards gun control reform in my community, I was excited to talk with other students around the country on what they were doing in their hometowns. I heard stories, similar to my own, of students organizing walkouts, lobbying legislators, and having discussions at their highs schools. Right off the bat, I was amazed to see the turnout. I wasn't sure what to expect in terms of numbers, but after seeing photos of Pennsylvania Avenue packed with marchers I was in awe. I was lucky enough to be right by the stage. From start to finish the program they had arranged had me on an emotional rollercoaster. One minute I was in tears and the next I had a smile from ear-to-ear. The level of eloquence each speaker had — despite their age — was outstanding and as I rewatch the videos on Facebook I still get goosebumps each time. 
Although Emma Gonzalez took my breathe away with her speech and Yolanda Renee King and Naomi Wadler restored my faith in young people, the speech that resonated with me the most was delivered by Cameron Kasky. He said, "the march is not the climax of this movement, it is the beginning". So many critics believe that this March is the end of our fight, but this generation will stop at nothing to rid this nation of the vicious cycle of mass shootings we have fallen into. The underlying message of this March was to educate yourself, use your voice, and vote. As a seventeen-year-old eager to get into the polling stations I could not have been more pleased with their emphasis on this as voting is how we can be the change we want to see in our country. Let's vote them out! “     
                                                                                             Cecilia - High School Senior

“I was blown away by the effort that must have gone into organizing this event - as a teacher I was inspired to see teenagers—students no different than my own apart from the tragedy they experienced firsthand—take on an event of this magnitude. And it was amazing! And yet as a mom I was saddened because here were kids so boldly standing up to adults begging for protection and safety that adults had failed to provide. We shouldn’t have to rely on kids to spread this message; they should be relying on us.
One of the most heartwarming and heartbreaking parts of the afternoon was seeing how the Parkland students had reached out to student leaders from other communities afflicted by gun violence. Living in the community we live in makes it easy to forget that we are comfortably safe—our kids don’t need to feel fear leaving their homes. The Parkland students reminded everyone that gun violence is more than just the school shootings that make national news - it’s also the shootings that minority communities experience on a much too regular basis.”                  Katy, Mom of 3



“I am generally very quiet when it comes to voicing my political views. Usually I can see and appreciate both sides of the fence on any matter, but changing these antiquated gun laws doesn’t seem to me an issue that can be reasonably justified without some significant change in policy. I have never marched or protested anything, but when I read the sign at the March, "It is so bad, even the introverts are here”, I thoughts, “yes, that’s me”! I hate making a racket, but please, please do something so we can better protect our children and put them on the school bus each day without this horrific fear in the back of our minds. Enough is enough.”                     Kara, Mom of 3


In the face of the issues of gun violence and legislation, I have often felt small, disconnected and powerless. Walking east across 86th Street to join the March south along Central Park West, I could feel the energy and see the crowd gathered - thousands of people, each each one the embodiment of a voice and a vote and a frustration with the status quo. Each person chose that morning to walk the city blocks, to make signs, to stand in the sun, to bring their kids/their friends/themselves. The March in New York City was just one part of a global chorus - connected and powerful. I was proud to add my voice and say enough.                     Kristin, Mom of 2 

For me, the March was not about politics. It was about teaching my kids valuable life lessons. If you feel strongly about something, stand up for it. If you see an injustice, stand up to it. If you want change, lend your voice to it, and if possible in person. I wanted my kids to see that regardless of age and socioeconomic background that we all have a voice that we need to use. As a mother I was so proud of the students who organized and spoke at the March. I am so honored that I could take my two oldest daughters and that they could see and hear first hand these students stories and their call to action. Two of the signs that I saw that really stuck with me, were “When our children are acting like leaders and our leaders are acting like children, it is time for a change” and “Teach your parents well”. My hope is that in the not to distant future I will be talking to my kids about all the good change that has happened.

The children have spoken and I am listening, are you?


This is original artwork by my oldest daughter. She drew it the night after the March. It says it all.