Jan's Story - Episode Transcript

Helen

Hi, I'm Helen, and this is Why Mums Don't Jump: busting taboos about leaks and lumps after childbirth. All the stuff that happens to your pelvic floor that no one ever talks about - incontinence, prolapse, pelvic pain. Problems that affect millions of women, one-in-three! I'm one of them. I have a prolapse. My pelvic organs fell out of place after the birth of my second child five years ago. And if you had told me then I'd be speaking about this stuff out loud, I’d have told you to give your head a wobble.

Helen

Hi and welcome back. Full disclosure today, right, my prolapse has been bugging me this past couple of weeks, and I think that's most definitely because I've not been doing my pelvic floor exercises, or much in the way of other exercise for that matter. And I just wanted to be honest about that. I do not have all this figured out. I am beating myself up a little bit, but there we are. I'm thinking now that I've said it on here, I'll have to get back to it. So that's it, really, just wanted to share that with you.

Let's talk about today's episode. So I spend a lot of time talking about pelvic floor problems, prolapse in particular, and framing it through my own experience as a mum of young children. You know I was 36 when it happened, I'd just had a baby. And I know that's the same for a lot of you, but I also know that the older you are, the more likely you are to have a prolapse. In part, it's to do with menopause making your hormones go wonky - I am not a medical professional - and that makes you lose muscle mass everywhere, including your pelvic floor. So if you hadn't been particularly bothered by pelvic floor problems before, you might be after that. And that's what happened to Dr. Jan Russell, who listens to the podcast and sent me a message. I really enjoyed chatting with her, and this is what happened when I asked her how I should describe her.

Jan

I was going to say, I'm a feisty old crone. I'm a coach and a trainer in neurolinguistics and I'm an artist, I'm a writer, I'm a gran, I'm a mum. Yes, I’m many things. I'm in my late 60s or my latter half of my 60s, and I'm enjoying life. So that's who I am.

Helen

And that's kind of the key thing, really, because I remember distinctly when I put out the first episode of Why Mums Don't Jump last year. And I got a lot of messages, as I do from women of my sort of age, with young babies who've just found themselves in this world of pelvic floor problems. And then I got one from you, I guess, kind of making the point like, look, this is distressing at whatever time in your life this happens, right? Is that kind of what you were feeling?

Jan

Yes, it was really. It isn't that you get to 60 and you prolapse and so it doesn't matter, because as everybody discovers as you get nearer to certain ages, they don't seem so old anymore. It's different perspectives, isn't it? At 60, I still felt quite invigorated, shall we say.

Helen

So I guess, if you don't mind talking about it, maybe you can just describe what happened with you? When did you first realise that you had a problem, that things were not as they should be?

Jan

Just before my 60th birthday. And my partner had planned us a really great holiday. And it was starting, it was a transatlantic crossing on the Queen Mary, and I'd never done cruising or big boats, but it sounded great. And the week before, when I was in the bath, I noticed that things were not as they should be and that there was some sort of pelvic organ dislodging. I don't know what we're going to call it, I often don't know how to say this, I often describe it quite basically. But I knew that the muscles of my vagina weren't right and they felt that kind of feeling of, wow, they're going to come out sort of thing. And I knew then that something was badly wrong.

Now, interestingly enough, in the two or three weeks beforehand, I had felt unusual sensations, so I think I had an awareness that something was going awry. But until that moment in the bath, I wasn't 100% sure what. And I suspect that as I was in the bath, I was kind of listening to my body and exploring, if you will, to find out what was going awry. So I was alarmed, I had visions of being in my glad-rags and dancing on the wonderful ballroom floor on this amazing ship, really not knowing what would happen next with my pelvic organs and that didn't feel great.

So I went to the doctors who told me what had happened. She said that it was a prolapse and that I would almost certainly have to have surgery. And then, of course, when I thought back, I did prolapse after the birth of my second child, my son, which was when I was 29. And at the time, I remember the doctors really saying and doing very little, telling me to do kegel exercises and saying if they didn't work, I'd have to have surgery. And I knew I hadn’t fancied surgery, so I had done kegel exercises, and I'd kind of forgotten all about it. So presumably after menopause in my 50s and hormonal changes and also doing a lot of working out unsupervised and I think at a gym and I think that contributed to be honest, positions of machines and things, but that's the kind of rough summary of how I knew I had prolapse, so that was step 1.

Helen

And this was just days, I guess, before you set off on the cruise, you went, presumably, did you?

Jan

I went and I had a great time, actually, I have to say. And I did dance, and I had an extremely good time. Of course, what I did was to be sure to rest up in the daytime sometimes, and again I did some basic pelvic floor exercises and then I went to my, had an appointment with a consultant when I got back. So yes, I did have a great time, once I got over the first alarm that everything would fall out and drop down completely.

Helen

Talk to me a little bit about that, what was that experience like for you? Because I'm just relating it to mine. It sounds like maybe you had a little bit more awareness than I did. For me, it was a bolt out of the blue, I'd never even heard of a prolapse, if I thought of anything pelvic floor related, I just was not expecting that. And I was yes, alarmed is the right word. And then that went into sort of quite a long period of feeling full of grief about it, really, and just really down about it. But it sounds like maybe you were a little bit more pragmatic, maybe, I don't know.

Jan

Well, I was quite scared, I have to say, and I was pragmatic because I wanted to go on this holiday, so I think I kind of very quickly got my act into gear, but I was alarmed, and I didn't know what it was going to mean for me. And I suppose there is an age difference, perhaps, as in I thought if I had to have a hysterectomy at that point in my life, that would be bearable, it would be okay. I'd had cancer in my 40s as well, so I'd had hormone treatment for my ovaries, so I'd kind of menopaused twice, so I guess, I wasn't grieving in that sense, Helen, I didn't feel that if I lost if I lost all my organs in a controlled way, shall we say, then I could have lived with that without huge grief. I was scared, really, of what was happening, and I felt ashamed and I felt kind of responsible, almost as if, what have I or haven't I done that has meant that this has happened all these years later.

And it is like, it's a hidden condition, isn't it? It's one of the many hidden conditions that we live with. Because on the outside, I’m five foot nine, I'm fairly robust, I look reasonably fit, but suddenly I was faced with, there are various things I've got to be very careful with here. And as you know I've heard some of your other podcasts, and in the early months, you have no idea, really, what you're able to do, and yet asking people for help is strange, and it isn't like you’re going to say why, to just anybody. So there's all that stuff, isn't there, that goes on, and I did feel a lot of that. And I felt, although I wouldn't have grieved my womb in terms of reproduction, I still was a sexual woman, I still am. So that felt also very odd.

Helen

Yeah. And I think a lot of people listening will relate to that, the more I speak to people who've been through it, the more it's almost textbook, these experiences, talking about you mentioned the shame and the blaming yourself, the responsibility - what did you do that made this happen? And when you take a step back from that, it's crazy, isn't it? Why should you be ashamed of this thing that happened to you? You did not do this to yourself. But it's really hard to get your head around that stuff.

Jan

Yes, it is. And I suppose it's because, let me say, I think it's great what you're doing, absolutely great. Because part of that shame, is well , is about women's sexual organs are not easily spoken about. And then there's all kinds of connotations, aren't there? The feeling of failure. Am I still sexual? Am I still a proper woman,  whatever it's going to be. So you are helping to break the taboo, which I think is fantastic, and it is a taboo. You don't sit around the dinner table and somebody says, well, how are you? And you go, well, I'm fine, but my prolapse is playing up and the organs are down a bit today.

Helen

Not yet, we don't, Jan, not yet.

Jan

Well, I could say there's certain people I can do that with, but generally speaking, you don't.

Helen

Who did you tell at the time? Did you have friends you could talk to? Was it something you felt you could be open about or not really?

Jan

I told my partner, who is empathic and understanding of that, and I think I told my sister, she's a little bit older than me and she's a practise nurse. And that was it, really. And then the next person I told was the consultant, I think. Oh, no, that isn't true, I was really fortunate, this made a massive difference to everything, was that I was having some support from Optimum Health, which is an organisation in Lincoln run by Lisa, and I can't think of her surname.

Helen

Somebody that understands it, and I know who you're talking about, because she follows me on instagram and (you) pronounce it Gimenez-Codd.

Jan

Yes, it is Lisa Gimenez-Codd. How I could forget that, I don't know, but it is. And she was brilliant because I called her and I went to see her. I'd had some lower back problems and she'd help me sort all those out. And she referred me to a specialist physiotherapist, which turned out to be incredibly useful, incredibly useful from the off, so I was very fortunate. And I think she was the only other person I told then Helen.

Jan

I don't think I told anybody else for quite a long time.

Helen

And then what's your journey with it been like since then? I mean, do you mind talking about your symptoms or how it's affected how you are?

Jan

No, I don't mind. I think I'm in a management process and probably will be for the rest of my life. I think that's how I experience the journey now. I did see a consultant at the local hospital and I knew I wasn't going to go back to her. She was very well, you can try your physio if you like, but it'll have to all come out at some point or we can use mesh. Now, I'm talking, where are we now, I’m talking over six years ago, so she wanted me to have surgery with mesh and I was instinctively and intuitively very clear I was not having any mesh inside my vagina. And I'm really pleased about that because we now know there is much more awareness of how incredibly problematic that can be. I'm sure it has worked for some women and if so, that's great, I also know it's very problematic.

So the journey since then has been through specialist physio, exercise and self care. And I would say that 85, 90% of the time I don't have any issues with my pelvic floor. I'm aware of it, if you know what I mean. I'm aware of taking care of it, but it's one of those things, isn't it? When I feel really quite good, I do strength training, which I did with Lisa as well, to begin with. If I feel fit and there's lifting to be done, then what I have learned, of course, is that I can lift if I do it properly, but if I'm over enthusiastic, say, if I'm not thinking care and just thinking, yeah, I'm kind of really fit right now, then every now and then I will feel the drag. I sometimes feel urgency with urination and if I'm kind of caught on an excessive laughter bout or similar, then I need to get to the toilet pretty quickly. However, so far I've been very fortunate, I've not experienced incontinence as a problem, so I'm grateful for that. And I really think this is very much about how I'm able to maintain the muscle, which is, as I age, I don't know what's going to happen with that, if it'll get more and more weak? Or, I’m unsure.

Helen

I guess you were in school and becoming a mother roughly 30 years or so, 20 or 30 years before I was. Did you feel like you had any awareness of anything pelvic floor related? Did you know much about postnatal care or menopause or anything?

Jan

Oh, no, not at all. I can remember when I had my first baby and I always remember kind of lying there, I had a birth without any drugs. I was very into, kind of hippie, I'm not having drugs that I want to be ‘at the birth’, which was great both times, I loved that. But I can remember having to have stitches after my first baby and this doctor, so embarrassed to be stitching me and telling me, oh so embarrassed, he couldn't name anything, he told me I'd have to wear bunny pads and I literally..

Helen

What’s that?

Jan

Exactly! Well that's where I was. I was like, what? I have to wear bunny pads. And it was sanitary towels that he was trying to say but he couldn't say sanitary towel to this woman of 27 who had just given birth, you know. So that was the era, if you like. And that was the, I had great midwives helping with delivery, fantastic midwives. But the doctors really were yes, they left a lot to be desired. And so when I went in after my second child and we knew that I had prolapse he mentioned the word prolapse, but I didn't really know what it was. I just knew that I had to do kegels. Nobody showed me, say, a model or a diagram of the pelvis, which, Lisa did all this with me, and the physio and it was so educative, even at 60 there was stuff that although I thought I knew a lot, there was a lot of stuff I didn't know about the pelvic floor.

Helen

Yeah, and no internet, I suppose in those days, although the internet is always the greatest thing to find yourself googling around this stuff but at the same time, at least you can get a basic understanding.

Jan

Yeah, it's funny, isn't it, Google? Because one of the nice things, actually, was my eldest daughter, actually one of her friends, who at that time, I think was in her probably late 30s, she had a prolapse. And I went out with them one night and she was talking about it so openly and we were laughing, really. It was brilliant to be in company where it was easy to talk about. And she was saying, you should Google this, Jan, oh, there's some awful ones on the internet. I'm like, I'm really not going to do that. But it was so wonderful to have that contrast between, if you like, my day of being in the late 20s and early 30s, sort of contrasted with my daughter's friends, was kind of refreshing, some shocking humour which was just brilliant.

Helen

Sometimes you got to laugh about it, right?

Jan

Oh about everything. Absolutely anything I believe you can laugh at and if you can laugh at yourself in good company, that's all the better, isn't it?

Helen

Absolutely and I was having a little look at some of the work you do sort of I'm going to say this wrong, probably, but coaching beyond menopause and into older age, has any of this experience informed some of that?

Jan

Well, probably I think because of the work I do and probably I do the work I do because of the person I am, you know how it's often a combination, isn't it, which comes first? I'm very much into resilience and I'm very much into resilient mindset and taking charge of what you can in life. So I think it has informed it because I also became aware of aging, as you very honestly said at the beginning, it's perhaps kind of appreciating that even though we're aging, everything impacts us. We still have feelings and thoughts about things and anticipation of futures. So I think it has. I think my experience with cancer, my experience with prolapse have both impacted me. And I'm very keen to support and encourage women as we go through any age, really. And because, of course, I'm post menopausal  in my 60s, I think there's such a need for women to be able to claim visibility and empowerment at any age, really Helen. There's kind of different issues in each decade, aren't there? But at any age, we are here and we have these bodily functions and they shouldn't be secrets or things to be ashamed of.

Helen

No. And there's definitely an issue associated with the, once women are beyond childbearing, once they've delivered their babies, we begin to be sidelined. And that only gets worse as you get older and then, as you say, the visibility, it's harder. Thinking about the women who might be listening, who are having that bath moment, recently found themselves in that position where they've just realised they've got a prolapse or, frankly, any other pelvic floor problems. What advice would you have for them?

Jan

My advice would be to investigate that prolapse with supportive care, so find kind of both medical and health professionals who you trust and really discover the detail of that prolapse because as you know they vary, don't they? Anterior wall, whatever. Find out where you're at and then feel whatever you need to. And also know that you can move on to really repair, support yourself in all sorts of ways. And there's no reason for most women I think, why you can't have a fit and healthy future, possibly more so than before. I think it's difficult to say don't be frightened because I think it's a bit frightening. But on the other hand, do know that that passes and that you can take charge. You can take charge. You need to really be confident, I think, to ask for what you want. Don't settle for advice, medical advice that, you know doesn't feel right. Feel confident, to ask for help. Even if you know you look like a very fit woman, if you know that you can't lift something today, ask for help. Don't be a hero.

Helen

And what did you say when we started talking? Be a feisty old, what was it?

Jan

A feisty old crone! Head towards your feisty old crone! So be a feisty young woman, be feisty. I do think this is about really if we stop long enough we do know our bodies, don't we? So kind of, fight for your body, fight for your body, put that feistiness into ‘you are worth looking after’ and do it as soon as you have any uncertainty.

Helen

Absolutely. And if your doctor says anything about bunny pads, set him straight. Or her.

Jan

Well, actually, change doctor immediately. You won't have enough energy to be educating your doctor, you need somebody who can help you.

Helen

Bunny pants, wow. I'd like to say that wouldn't happen today, but honestly, after some of the stories you've told me, I can't be sure, there's definitely still work to be done. Jan, by the way, is @drjanrussell on Instagram. That's doctor,  D-R, Jan J-A-N, Russell. R-U-S-S-e-l-l.

Next week, Amanda Savage is a pelvic health physio who knows everything you need to know about pelvic floor gadgets. From weights to biofeedback, magnetic chairs and devices that let you control video games with your pelvic floor. If there's a collective term for this stuff, I haven't found it yet. I'd quite like to use the word 'vadgets', like vagina and gadgets, but it might have already been taken, so I don't know. Your thoughts are welcome on that.

You can now support Why mums don't jump at buymeaccoffee.com/whymumsdon’tjump, and it can be completely anonymous, if you prefer. You can find the link in the show notes or on social media @whymumsdontjump or online at whymumsdontjump.com.

Again, I'm not a medical professional, so please don't take anything you hear as medical advice, but do get involved: post a review, tell me what you think and spread the word. You've been listening to Why Mums Don't Jump, with me, Helen Ledwick. Bye for now.