Friday, August 15, 2008


So aside from the increase in BP meds, I am now faced with another medical issue that warrants some reflection. I have been to see a specialist in KKH to assess and treat my pelvic prolapse. Three months ago I was asked to try kegels but I don't think it worked very well.

The doctor examined me again and said that kegels really only work to maintain the situation - they don't make it better.

So the cards were laid out quite clearly for me:

The rectocele was at stage 3. The cystocele was at stage 2 and the uterine prolapse at stage 2. My pelvic organs are folding in upon themselves and threatening to collapse in a heap! There are 4 stages of organ prolapse and as you can see, I'm pretty much almost there.

Surgery is the only way to go to correct this. I've known this for a while, but yesterday the doctor threw me another curve. He said, not only surgery but hysterectomy - removal of the womb via the vagina.

It was necessary because the uterus imposes additional weight, and hence, strain on the pelvic floor. Surgery can be done without the hysterectomy, but the results may not be as good and the risk of a relapse happening is greater. So, he said, if I have completed my family, then this is the way to go.

I asked for a reference point - how major is this? Is this like, recovering from an episiotomy? Dumb question. He said no, this was much much more than that and if a hysterectomy is involved then its even more major. I would have to stay in hospital for about 3 days I think.

He says the pelvic floor prolapse could be due to a lot of reasons - and my 5 vaginal births are not necessarily the key cause. He said even women who have had no children encounter a pelvic floor prolapse. So its not just about childbirth. But likely due to the multiple episiotomies, the lack of kegels (guilty as charged!) and possibly, for some women, genetic factors which predispose them to weak pelvic floor tissues.

I asked about the pain factor - he said his overseas patients could walk home the same day but in KKH they prefer to keep patients overnight. Okay, I don't think I want to walk home on the same day. The doctor says that a week after surgery, the women are walking like they never had surgery between their legs. Hah!

The implications are, I would not be able to carry Trin or anything heavy in the long run as this would strain the pelvic floor.

How do I feel?

Well, the only pros to losing my womb is that I will no longer menstruate! No more messy periods - the end of 'the curse'. Yay!

The cons, though, are many. For one, I can no longer have children. Yes, I know for many women they think that five is already enough, or maybe even too many! But I feel very sad at the knowledge that I will no longer be able to bear children. I have had happy pregnancies and enjoyed every single one of them. I have enjoyed my labours and births. My trusty womb has harboured five tiny lives and I will surely miss it.

Women angst over losing their breasts to a mastectomy. Why should the angst be any less for a woman facing a hysterectomy? Breasts can be reconstructed but wombs, once gone, are gone for good. The ability to bear children is a gift and the womb is one of the core symbols of feminity and womanhood. I have been blessed and I treasure this gift so much.

Keeping my womb does not mean that I will just have more children. But now, confronted with the possibility that I can no longer have more, I am thinking hard about this.

The reasons for not having more children are all sound - my kids are all growing up already, Trin will turn 3 and will soon be more independent and I will be free of the early mothering responsibilities like nursing etc. Then there are the health reasons - eg the prolapse (having another baby will definitely worsen the prolapse!), the blood pressure is already unstable and poorly controlled, my kidneys are already leaking protein and any future pregnancy will strain this even more, I am not getting any younger and as KH said this morning, even the last pregnancy was tiring and the BP shot through the roof... He said that he was open to closing our factory for good because the health risks to me were just too many.

But at the same time, I have always been open to the idea of having more, thinking it would be nice to have one little boy and to have the sort of birth I've always wanted. I know, I know... no guarantees that the 6th baby will be a boy. But gut feel can be so strong... just like how it was when I conceived Owain in Australia all those years ago - I knew it would be a boy.

I've read that having a hysterectomy to treat a prolapse may also lead to other conditions such as a vaginal vault prolapse. And having a pelvic floor repair may also lead to other painful conditions too... Honestly, its like between the devil and the deep blue sea! There is also no guarantee that the pelvic floor repair will be totally successful - I've read instances where women report painful sex after that, where they no longer feel orgasms and that recovery is long and extremely painful. And worse, multiple repairs when earlier ones fail.

Awful thought huh?

Well, I will mull it over. KH and I will decide by end Aug.