I Survived Sphincteroplasty Part 12

cmansmommy

I'm a newbie to the thread, but have been reading for a couple months now. I guess I'll start by telling how I ended up here.... In July 2008, I gave birth to a beautiful, very "healthy" boy. My son weighed in at 8lb 10oz.....with very broad shoulders. So good ol mommy here got a 4th degree extension of my episiotomy. For the first week things were ok. During week 2 post partum, I developed a bad uterine infection as a result of tearing into my rectum. I got over that and was ok, or so i thought... Within the first month I started experiencing anal leakage. By three months out, I talked to my ob/gyn about it and she told me it was too early to do anything yet, to adjust my fiber in my diet and wait a little longer. At 6 months out, I had had enough. I couldn't go to the mall and walk around without having leakage, I was having accidents every other week if not more often. I saw a specialist in february (7 months out). She has recommended a sphincteroplasty but had me wait to come back to see her again after trying kegals and diet modification and fiber supplementing.....2 months later that isn't really working at all. In fact things have gotten worse. I go back to the dr april 23 to discuss where we go from here. I have a lot of questions for her naturally. I am planning on proceeding with the surgery in June (have to wait for sick pay at work). She told me i could expect 3-4 days in the hospital, 4weeks off work, and "to seriously think about my childbearing plans as the pressure from carrying another baby can cause damage to the repair even if it is a scheduled c-section". That's all she has said so far. Now mind you, I am an OB nurse, so I know I can have a c-section in the future if we decide to have another baby. So that's my story of how I ended up here.

I guess really why I am here is to see if anyone else this young had had the surgery and I was wondering how long the time in the hospital and how long off work other people experienced.

sbremom

Cmansmommy
Welcome...you have found a great place to get advice, ask questions and just vent. Most importantly this is a great place for support. I don't have much time right now, but I wanted to tell you that there are a few of us on here that were in your same shoes. I had my baby last april and had the surgery in august (i am 28 years old by the way). It was the best decision for me. I was in the hospital overnight and then went back to work 4 week later I think it was. For some the recovery is longer. The biggest thing is to have help lined up esp for the first week or two since you have a little one that required attention.

In terms of another baby...my sugeon said it would be fine as long as it is a c-section. That seems to be what most of the ladies doctors told them on this thread. I am going to see my obgyn in may for my yearly and have a bunch of questions to ask him and see what he thinks about another baby, since I know he has been practicing a long time and has seen others go through this surgery. I will let you know what he says then.

Feel free to ask questions or just vent whenever you need to. I am sure others will be posting on here soon.

spring08

Hi everyone,

Sbremom: my PT recommends doing 2-3 sets of kegels per day (10 kegels per set). It is all in the quality of the kegel and not the quantity. What she has me do is breath in from my belly (not chest), and while I am breathing back out, do a kegel while counting to 10. Count to 20 in between each kegel to give the pelvic floor a good rest. It sounds confusing, but once you get the hang of it, it's easy. Let me know if you have questions!
Oh, in terms of the leakage, I was told that I have nerve damage either from childbirth or the surgery (which can happen), so that's why I leak after BM's. I think everyone is different.

Cmansmommy: I'm so sorry to hear about your troubles. No one wants to go through this! I had my s-plasty to repair a fistula as well as the muscle. All in all I am glad I did it b/c no one can live w/a fistula. However, I do have leakage after BM's now, but it is most likely from the fistula repair and not just b/c I had a s-plasty. All of the docs I have seen or talked to (and I have talked to many) told me that the repair should be fine as long as I have a c-section. Of course I am scared to death of ruining anything, but it's really a very personal decision and it all depends on how comfortable you are taking on the risk. That said, a woman has a risk of injuring herself even if she hasn't had this surgery. I wish you well and ask any questions you have--most of us have either been through this or are currently going through it!

Take care!

sbremom

Spring--thanks for the info...do you do these standing up and every day? Good to know about quality not quantity. Is it basically the muscles you use to stop the flow of urine? That even helps the sphincter?

Nerve damage makes sense which would explain why it is so hard to get everything out even when we want to. Beleive me its back to fiber tomorrow...easter has done a number on me! Do you find you are leaking after every bm?

Spring...have you and your husband made any decision regarding another baby? How old is your one now? As I said before I go June 1 to see my obgyn so I will let you know what he says as well, but my surgeon saw no problem with it at all. I am glad to hear you are feeling better since PT. Thank you again for sharing the info.

cmansmommy

Thanks for sharing. around here, no one knows what I'm going through, so I turned to the internet for help. I currently have leakage after bm's and sometimes even without having a bm recently. they say it's nerve damage as well as the physical damage from childbirth. i'm scared that i'm going to have the leakage even after the surgery. i've made up my mind though that I am having the surgery. the dr even said last time I was there that I "am a great candidate for surgery and should have success with it." only 1 more week til i go back to hopefully get it scheduled!

sbremom- I'm 25, so i'm glad to know someone close to my age is talking to me! My OB is fine with me having another baby, it's just the surgeon and my husband that aren't. But with that said, I am still willing to accept that risk and have just one more baby if I can convince my hubby to try again in a couple of years.

sbremom

cmansmommy
Believe me you are not alone and if you think people around you don't know what you are going through they might, but are just don't want to talk about it. That seems to be the case.

In terms of age...there are quite a few of us on here that are young...spring and kim are also I believe in the early 30s and Kelly (the one who started this was also young). I think many women who are older have dealt with it and are just now realizing it can be fixed.

By leakage do you mean the continual wiping? For me I have the same thing if I do not watch what I eat but to me that is better than the alternative of having things come out before I get to the bathroom. :-)

What is your husband scared about with another baby? THe risk? It is hard and it is something I am concerned with too, that is why I am anxious to talk to my obgyn about it. He has seen other women go through this surgery and I want to see if he can tell me of those who has then went on to have other children. My surgeon even said some women have this surgery and then opt for a vaginal delivery. No way in hell...I mean a c-section will not be a walk in the park but better than messing up the surgery!

Question for the other ladies: I sort of asked this before and spring mentioned scar tissue. I am still having that feeling right by my vagina of something hard. Did anyone else deal with this...I know it can take a while to fully heal so maybe that is it. I also know he rebuilt my perinium so it could just be the new "me."

Keep us posted and keep your head up. You will get through this as all of us have. This board is a god-send believe me!

cmansmommy

sbremom: The leakage is not only the continual wiping after bm, but also i have leakage that is enough to ruin my underwear if i do any exercising (running, walking for extended periods of time) and sometimes i just have the leakage for no reason at all. If have a large bm, i have leakage all day after it and sometimes even the next day. I recently changed jobs to work in a dr's office/urgent care center so that i can go to BR when i feel the urge. If i wait to go (more than 5-10 minutes after the urge) I have leakage that is sometimes liquid, sometimes semi-soft.

As for my hubby, he's scared that carrying another child will cause leakage because the doctor said due to my extensive nerve damage that carrying another child will stretch that nerve and I may have leakage issues again even if I have the surgery. I AM having the surgery, I decided that a long time ago. I go this Thursday (23rd) to schedule it hopefully.

sbremom

good luck and keep us posted. Ultimately it has to be your decision and I am sure your husband will support you either way. We will all be here for you and any questions you may have.

DId your obgyn tell you that about carrying another baby or the colon rectal doc?

jenwithfourkids

Hello there, I posted this earlier in the week under it's own thread but got no replies - once I realized that people actually subscribe to threads and get notified of activity I figured I should move my post here...Thank you in advance for reading my story and offering any advice or comments you may have. I have spent the last three days reading each of those threads - what a wealth of information! It's overwhelming and I now have a huge list of questions for my doc, though I'm having trouble organizing them in my head so that I can ask them clearly.

Let me tell you a little bit about me; and then I have a question that I'm pretty sure someone here can help me with .

When I left my doc's office last week I was so excited that he could "fix" me. Then I found these threads and I'm totally reconsidering my excitement.

I am 42. My son just turned 9. He will always be my little "pain in the ***"! He was baby #2 for me (I now have 4 kids) and he was VBAC (and my only vaginal delivery). He was 8 lbs 13 oz and was three weeks early when my water broke. I hadn't decided if I wanted to deliver vag or have another C but I was terrified of delivering vaginally. So scared and tense that I think I was getting in the way of my own labor and when my doc (actually my doc's partner) told the nurse to prep me for a C I totally relaxed. When I relaxed, the baby moved down and when the doc came back from lunch he decided I should deliver. Well - forceps, vaccuum and a 4th degree episiotomy later, I had my son. It was a terrible experience, but hey, whatever, it's over. Except that it's not!

When my son was 9m old, I got pregnant again and started having BM issues. Nothing terrible, no accidents (that I remember anyway, it was a long time ago), just feeling as if I never finished what I started when I tried to poop! Or I'd think I'm done, stand up and realize I wasn't. Or go back to pee hours later and realize my underwear was dirty. Or having a BM after my shower and needing to take another shower to get clean again....on and on, as you can imagine, I'm sure.

(It's amazing to me how many of the posts here describe what happens so clearly - such a great feeling to know that I am not alone. So many times in the last few days I've read a post and thought to myself, "OMG, that's EXACTLY what happens to me!")

My OB referred me to a Colorectal surgeon who I absolutely hated. Granted, I was pregnant so there wasn't much he could do, but the man was an a$$hole. No compassion, no bedside manner, I felt that he thought I was an idiot for coming while I was pregnant. Anway...fast foward 8 years to now....

I still have the same issues - not much worse, pretty consistent over the years. When I have to go, I have to go! I know I have to go; just can't tell always when I'm done or I know I'm not done but can't finish. I have had a few accidents - one in a restaurant, thought it was gas, it wasn't - one when I was nowhere near a bathroom (in fact, I was on the subway with a bunch of friends and my kids). I can't even count how many times I've burned pancakes or raced home in order to make it to the toilet.

What made me go to the doctor again is that I've been training for a race; I am running a half-marathon on Sunday. During many of my training runs I've had leakage - sometimes lots of it. I've gotten to the point that it doesn't bother me too much (sick, what we decide is okay). It's only bad if I'm on a run and I have to go... then I'm stuck. If I'm on a run and I leak a little and don't know it until I'm back, well, I'm back so I toss the panties and take a shower. No biggie.

Wow, this is getting long - thanks for hanging in as I'm not even to my question yet!

I went to my OB, he suggested another doctor. This doctor was WONDERFUL! Easy to talk to, explained everything, his staff is great. He did an exam (probe, speculum, stuck me with a toothpick to check external nerves). He said that my outer sphincter is a horseshoe shape, he said that there is a timy tear in the innermost sphincter (the one that is involuntary and should always be closed unless you are going). He said the space between my vagina and my rectum (perianeal or perianum?) should be one inch long is only 1/4 inch.

He said that I am absolutely a candidate for an overlapping sphinteroplasty. He said that the success rate is 85% (what happens in the other 15% of cases?)... do they get worse or simply stay the same? He did say that the nature of our muscles are such that they may deteriorate again over time - related simply to age. So does surgery today make that better tomorrow? Or is he saying that I will be no better come my 60s and 70s anyway? He was pretty up front about the duration of recover time - at least I thought so until I found this forum. I guess I'm curious of the posters here who have had such a hard time recovering had more extensive issues than I have or had more than one procedure done at the time....???

He is sending me for an anal EMG, an ultrasound and a defogram. He said that my external nerves seem fine, he said that he didn't see (or feel) any evidence of a recotcele (I think that's what he called it - a little pocket is how he explained it).

While I'm not sure I will go through with the surgery, I figure that it can't hurt to go for the tests. I may as well know the extent of the problem. Expecially since reading all of these posts makes me realize that I actually am quite lucky that it's not worse. I'm not sure I'm willing to give up 6-8 weeks of my "so called normal" life to fix a problem that isn't a HUGE issue for me.

So, any advice that anyone might have would be carefully considered! What questions do I need to ask??

Okay, finally my most immediate question. I am running in a half-marathon on Sunday. I am most afraid of having an accident like I did during one of my long runs. I want to do all I can to prevent that and have considered not eating (HA - that's not possible!). Does anyone have any tips on how I can safely do that? I plan on taking an immodium, and I plan on doing a warm water enema before I leave my house for the race. (Leaving at 6:00am, race start is 8:00am, I plan on finishing in just over 2.5 hours.) I am hoping that I have to poop when I wake up that morning - though if I don't, I assume that the enema will help that.....?? What are your thoughts on that?

(I do need to add that there was a stomach flu going around my family that week that I had the accident during my long run - I might have had a touch of that. I also had had coffee before my run AND I used a rehydration GU with caffeine in it....all those things probably worked against me and contributed to any gastro issues I had that day - and of course, I will not be doing ANY of that on race day. After that I ran another long run and with one bathroom break around mile 8 (I stopped to pee and actually had a little BM unexpectedly too) I made it home with clean pants! That felt like a huge accomplishment! To only be focused on the strained leg muscles was like a gift that day and I'm hoping that I will be just as fortunate on race day.

You are all so strong - I admire your efforts to get through each day facing the issues you face... thank you in advance for any advice or comments you might have!!!

Jen

cmansmommy

OK, so I'm back from the doctor.......URGH! So i go there today thinking we are going to schedule the surgery.....NOPE! She wants me to wait 6 more weeks. Apparently all the kegals I'm doing are helping. She says I have more muscle tone now than 2 1/2 months ago, and that if I had nerve function she would do the surgery now.....Big shocker here ladies, I have no nerve function! So the surgeon suggests waiting 6 more weeks to build up more muscle bulk before we discuss the surgery again. I just want to be done. Why doesn't she understand that?!? She told me i can't lift my son for 2-4 weeks which i told her was no problem because my mom is off all summer, then she says lets wait. If I don't have it done this summer, I have to wait until next summer. I have no help at home unless my mom is around, my husband has to work, he can't just take 4 weeks off with no pay to stay home and help with my son. She still says I need the surgery, just that it's not quite time to do it yet. I'm so frustrated I could scream. I told her I had to change jobs because if it and everything and got no where. I just broke down when she left the room. I bawled. I am so ready to be done. I just want to be able to take my son on a walk to the park and not leak. Is that too much to ask????? Sorry this got so long, I just had to vent somewhere! THe only good that came out of it was she changed her tone about having kids in the future. She told me as long as I wait a couple years and have an elective c-section I can have another baby. That still wasn't enough to keep me from crying though.

penny70

Hello,
Just posting to 'announce' my try at pelvic floor massage. I have to travel over an hour to get to the PT place that does it. There's nothing in Western Mass so east I go. I'm hoping somehow this will help my leaking and other surprises. Maybe there'll be some helpful hints. My situation is one where I have significantly more problems now than I did pre surgery. Just a word of caution, to try any nonsurgical options you can before committing to something that can be less than successful. My daily routine is now cottonballs, enemas a few times a week and an occasional surprise out of nowhere that's really disconcerting. Pre surgery I had skid marks if I walked over an hour but had nothing else to contend with. Now every day is a dilemma. I need to think ahead but I wish I had been told before hand what to expect and the possibility of complications like fistulas-and then ostomies and then leaking. Well, enough of that. Good luck to all of us.
Penny

jenwithfourkids

Hi Penny,
I am sorry for what you are going through, but very appreciative that it pretty much cemented my decision NOT to go through with any surgery at this point in my life. Can you tell me though what sort of procedure you had? Was it only sphincteroplasty or was it more?
Thank you!
Jennifer

penny70

Jennifer and all,
Originally, it was the sphincteroplasty with something else but I'm embarrassed to say I'm not sure what. After the s-plasty I also had an impaction that caused more damage. When I told the MD's office, they told me it was 'healing pain'. That did more damage. Then there was the fistula. I'm thrilled that's not there any more but the rest feels overwhelming at times. The PT I went to today sounded encouraging. She'll be working on the internal scar tissue and even my hips and abdomen to try to make me better at the pushing aspect of a BM. After driving all the way back from PT I went to the mall and found a 'gift' when I got home. Didn't even feel it come out. Very frustrating. Feels like I can never walk for an extended amount of time again but I have to keep telling myself things will get better.
Penny

rjsmom

I've been reading this board for sometime and I must say all you ladies have helped me during this trying time in my life. This question is for sbermom as you too experienced leaking after bm or for anyone else who can answer my question.

I had a beautiful baby boy on Jan. 2/09. I experienced a traumatic delivery with thrid degree tear with a small laceration to my anal sphincter muscles. I must also add that he was delivered with forceps. I thought I was all healed but thrid month postpartum I began leaking stool after bm. When it first happened I thought that maybe I just didn't wipe get enought but boy was I in for the surpraise of my life when it started happening after every bm. I discussed this issue with my obgyn and after he checked my anal sphincter muscle he said the muscle was intact but was weak and that I needed pt to strengthen them. So I've been doing my kegels and using fiber supplements which seems to be working. My doctor tells me that this problem will go away with time.

Sbermom did your leakage after bm go away?