Sara'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. And if you had told me back then that I'd be speaking about this stuff out loud, I would have told you to give your head a wobble.

Helen

Hi. Episode three of the third series already! How did that happen? Thanks to everyone who's been listening, sharing or writing reviews, getting in touch on social, it all really helps to get the podcast out there. And it's so cool to know that there are women all over the world listening and feeling all the same feelings. So welcome. I'm very pleased to say that today's episode is sponsored by EVB Sport and Core. They make engineered clothing which supports women with prolapse or incontinence. There's a range of leggings and shorts that act like scaffolding for your pelvic floor muscles and they're clinically proven to help reduce leaks and improve posture. I've heard lots of good things about them in the last few years and EVB very kindly sent me a pair to try, which I ran in the other day and felt very well supported. For me, it's like another layer of protection to prevent things getting worse so you can find them at evbsport.com. The team there are lovely. They can help you find the right size. And if you fancy trying a pair, you can get a 10% discount by using the code ‘whymumsdon'tjump’ <expired>. Thank you to EVB. So I think this is a bit of a special episode. It's with someone who got in touch on Instagram a while back. She's a mum of two who lives in Essex. She's a primary school teacher. She listens to the podcast and she has a really inspiring story to tell. She is Sara Duckett, and her pelvic floor problems started after her eldest son was born in 2016. She was induced, there were complications. She ended up with an episiotomy and forceps, that was the start of it.

Sara

And the recovery after the birth was well, I was all over the place. I was having a lot of issues with, like, leaking urine, not able to control anything at all, not able to exercise, walk, because I would just basically wet myself. So I was having to wear the really thick pads to try and just combat all of that. So because I'd had the forceps delivery and the episiotomy, the hospital had referred me for women's physio to the women's physio team. So I think after about six months, I went and had my first appointments and they assessed everything and they said that my pelvic floor strength was really poor and they gave me some exercises to do and all of that, and I went for about another three months for appointments every week. And it just wasn't getting any better, despite doing the exercises. And we got to the point where the physio I was seeing, she basically said, look, there's nothing else that we can do, apart from if you have an operation to fix everything. And then she said, but they won't give you an operation if you want to have more children. So I was like, oh, right, okay. So at that point, I was just left, I was still leaking urine, I was still having lots of issues, wasn't able to exercise, and it was really starting to affect my self esteem and everything like that.

Helen

And this is, like, going on, I guess, the whole, what, first year of your baby’s life?

Sara

Yeah, well, constantly, until I got pregnant with my second child. And I saw a different, I switched hospitals and I saw a different set of midwives, and I was speaking to my midwife about some of the issues that I had after my first born. And it was only after speaking to her that I actually realised,  well she said to me ‘you shouldn't have been left like that. You've been suffering with a lot of things.’ She said ‘there are lots of things that can be done to help you, forget about the operation. There are lots of things in between that could be done’. And I was like, oh, I didn't even know. Literally, I just thought that that was my life. I was always going to be leaking urine and that was it. And she was really good. So before I'd even had my second baby, she'd already set me up with an appointment with a urogynecologist, and she said ‘six weeks after you have your baby, you've got this appointment, you go, she'll assess you, and then she'll work out the route that you need to take.’ And thank God she did that, because after having my second baby, I mean, completely different birth, it healed a lot of the traumas, I think, of the first birth, thank God. So I had a water birth with my second and everything just went absolutely amazingly.

Helen

I'm so pleased for you.

Sara

Yeah, I was so, so pleased to have that experience. And I know not everyone does. And I did feel with my first, I felt very cheated because nothing went right and it was just such an awful, traumatic experience and I feel like it just put me in such a bad bad place. But I feel like my second birth, I realised that it wasn't my body that had failed me. It was just the circumstance, it was just what had happened at the time. And it wasn't anything that I'd done and I could actually give birth on my own. And I did it, and I felt so proud of myself but unfortunately, having the second, he sort of compounded a lot of the problems that I'd had before. And when I went for my first appointment with the urogynaecologist, she referred me to the women's health physio again. And when I had my first assessment, I was diagnosed with having a prolapse. And at that point, I had no idea what that even was and it was just what? And it was really scary. And the prolapse she diagnosed me with was a rectocele. So the way she explained it was that I had my stress urinary incontinence and then the rectocele that I had was causing a lot of the problems I was experiencing with my bowel as well. So after my second baby, I was not only not able to hold onto my urine, I wasn't able to hold onto a bowel movement either. So that was just like it wasn't a great time, to say the least.

Helen

And this went on for years then. I mean, this is like, what, four years up to this point?

Sara

Yeah, so it was over the course of four years. So at first when it was just the urine side of things, I thought, okay, well, I can cope with this, I can use the pads. Yeah, it's not ideal, but I can cope with it. But when I started to leak poo as well, I didn't want to leave the house. I was very conscious all the time of the smell and stuff like that. And even though I never had an accident while I was out of the house, if I would walk particularly fast, even I would have like, some leakage when I got home. And I'd just be so aware, hyper aware of everything, and it really took a massive toll on my mental health. So, yeah, it wasn't a very good time in the first year after my second son was born, I just felt like I was in just an absolute state. So, yeah, it was hard.

Helen

It's just an awful time for it to happen. Not that there's ever a good time for it to happen, but when you're looking after a toddler and a newborn and you're trying to navigate that at the same time, that impact is huge. Because if you're saying you were barely leaving the house, then that's the only thing that sort of keeps you sane when you're sleep deprived and looking after your toddler, so it must make it even harder.

Sara

Yeah. The thing that sticks in my mind was sort of six months in when I was weaning him and I'd got all his lunch ready and everything, and he was sat in his high chair in the lounge and we were eating lunch and I got the urge that I needed to go to the toilet. And I knew I couldn't leave him in the lounge eating because obviously it wasn't safe. So I had to drag him in the high chair to the downstairs toilet and he was, bless him, still eating his lunch while I was there on the toilet, like, sorry about this. Obviously they don't care, do they? But I just was thinking, I can't live my life like this, I can't carry on. I'd got to that point where it was just so hard to do just everyday things, walking, going up and down the stairs. Heaven forbid if I got a cough or a cold or anything like that. It was affecting me at work when I went back to work as well. And being a teacher, you can't just leave the classroom easily. It was a lot to take on.

Helen

That’s the thing. I mean, it's one thing talking about the physical impact of some of these problems, whether it's discomfort or whatever level you're on, even if it's just a bit of leaking, but for me, a lot of it has been like the mental impact. Beyond that, my problems are not that bad, but previously, just like thinking about them all the time and I felt like they'd kind of, sounds a bit like whatever, I felt like sometimes like it had just taken a bit of colour out of my life or something. I couldn't quite… I'd be with my kids and I'd just be thinking about that and then I'd get annoyed with myself for not taking pleasure in these wonderful children

Sara

And everyone says you’ve got such wonderful children. Got such lovely children. Well, at least you've got the lovely children. And you'd feel guilty. Well, I would feel guilty for complaining about it. And then I'd feel like, god, people are so desperate to have children. Some people can't have children. And I've got two beautiful children, and yet I'm just so unhappy. And I just felt like the odd one out all the time so my husband would be able to run about with them and do different things at the park and pick them up, and I would just feel so on the sidelines because I just couldn't do any of that. It's just really sad, really.

Helen

And it is that guilt as well, because there is just this social expectation that as a mother you would give up anything and everything for your kids. So you are not through choice, giving up a level of living, I suppose, like a level of running around and a level of happiness and all those kinds of things, and you should just accept that, because that is just what a mother should do. You should suffer anything for your kids. But obviously that's not true. We need to be happy to give them a good upbringing and give them the joy in life. They don't want a sad mummy.

Sara

No. And I definitely realise that now, because the more I was dealing with these issues, the more my mental health was declining. And I didn't realise it, I think, until I got to a sort of a breaking point and you try and talk to other people about it and other mum friends, that I had, but no one was going through anywhere near what I was experiencing. And I felt weird and I felt like my body had done something wrong. And I kept thinking, everyone else is okay. Everyone else has had multiple children sometimes and they're fine. Why has this happened to me? And I think once you get into that sort of spiral, it's very hard to pull yourself out. And thank goodness, really, that I had very supportive people at Southend Hospital, where I was having all my appointments and they realised, I think, how hard I was finding things. The lady in particular that really helped me was called Karen Bennett and she was a nurse practitioner and she did a test, I can't remember the name of the test now, but she basically had to put a balloon up my bottom and work out the squeeze pressure that I had. So it was a test that I was having to work out what treatment I needed to go. It was lovely.

Helen

Oh the glamour!

Sara

It was on New Year's Eve as well. And I remember saying to her at the time, this is not how I pictured spending my New Year's Eve. So, yeah, as she was doing the test afterwards, I got really upset and I was speaking to her about different things and she spoke to one of the consultants and he phoned me and he was part of the colorectal team at Southend. And he phoned me and I spoke to him on the phone and got upset again. And he said, look, I'm going to refer you to our psychiatry department. And thank God he did, because after having obviously the lockdowns happened as well, so there's no support there. But I was able to have support through the psychiatry department. I had online therapy sessions every week for, I'd say, about sort of seven to eight months, and it was just invaluable, it got me back on my feet again and it helped me to realise that it's a medical condition that I have, but it doesn't define who I am. I can still live my life and I can still go and do things, but I just have to make adaptations. And I think now I've accepted what's happened to me, it's helped me to move forward and to seek the right treatment and to not settle for how things were. I realised I didn't have to still live my life like that and there were lots of things out there that I could do and try to help. Thank goodness. Thank goodness for that, really.

Helen

I'm so pleased you have that kind of care, people reaching out to you and saying, look, we can help you in this way. Do you think you'd never have done it off your own bat?

Sara

I just didn't even realise what was out there, what help was out there. And I think that's the saddest thing. And during the time I was having my therapy as well, my counsellor encouraged me to maybe try and find some support groups and I found a really great one on Facebook. It's called Female Pelvic Organ Prolapse Support Group. And it's got thousands of members on there. And I went from feeling like I was the only person suffering from this to then, you know, finding out about you and your podcast and talking to other women that were going through similar things. And it just helped me feel not as alone and actually realised that this is something that happens to a hell of a lot of people. And the experiences of people and the help and the care they receive are just worlds apart, depending on who you speak to, where you live, or even on the day that you ring up and speak to someone. And it seems wrong to me that not everyone can have the experience that I've had, which is what's made me want to talk about it and get the word out there, really, I guess, similar to yourself, to try and make it so that not everyone should feel this way, that there are options.

Helen

That's exactly it. And it breaks my heart that it's not just available to everyone. And the idea that there will now be women in that position just who are barely leaving the house, at home with young children and it's really sad. It should be. And again, that's partly wrapped up in all the secrecy and taboo around it, right? Because if you're not talking about it, you're never going to know what's out there or it's just  you locked in your own head thinking that you've broken and all the rest of it.

Sara

Even the word prolapse, I couldn't say until I had my therapy. I couldn't bring myself to say the word prolapse because of all the negative connotations that it had. And I just think to myself, I always used to say, oh God, if only I'd broken my leg or I'd broken my arm, it's so much easier to talk about. But as soon as you start mentioning urine, poo, and you see people's faces, like, urgh.

Helen

We've got to get past it, though, we've got to get past it. It's so prolific. We need to...and we are doing. We're chipping away. Tell me a bit about your treatment because you're in a much better place, aren't you? What's been the process for you?

Sara

So after I had my second, I went to see the women's physio at Southend and she helped me retrain my pelvic floor muscles and also the muscles in my bottom as well, which I didn't even think you could do.

Helen

So, like the sphincter, kind of situation?

Sara

She gave me a device to use. It's a biofeedback.

Helen

Okay, so that tells you how hard you're able to squeeze something, isn't it?

Sara

Yes. So it's like basically like a probe that you put into your bottom and then you do your pelvic floor exercises and it all draws up and you can see on the monitor whether your squeeze pressure is getting better and you can hold it. And the thing that I had a problem with was the relaxing as well. So everything I could squeeze everything, but I couldn't relax it, which I think a lot of people don't realise when they say, oh, yeah, I'm doing my pelvic floors, you don't realise there's actually a lot more to it. So I would definitely say to anyone, if you haven't gone and had that part of the treatment, definitely to do that, because I thought I was doing them perfectly. And it was only after seeing her that I realised, oh, there's actually another side to this. So I saw her. I then went and saw Karen Bennett with the Colorectal team at Southend and she gave me a series of sessions called PTNS, which they basically they put a needle, it's like an acupuncture needle, they put that in your heel of your foot and then they put an electric current through that needle. So it sounds a lot worse than it is, but it doesn't hurt at all.

Helen

I mean, it sounds mad. It does. Before we spoke, I'd actually seen that you'd posted about this on the Facebook group, charting your experience of the PTNS thing. I'm not going to like it. Initially, I was like, what is this? This sounds a bit…because there are all sorts of crackers therapies out there.

Sara

I didn't think it was going to work.

Helen

But it is, so I looked it up and I'm going to say it wrong, but it's Percutaneous Tibial Nerve Stimulation, something like that. It is, as you say, available on the NHS, at least in some areas, and it stimulates the nerves that are responsible for your bladder and for your pelvic floor. So you went every week and they stuck needles in you?

Sara

Yes, basically. It's just over a year ago now and I went for six months. Every weekend, every Saturday morning, I went, and that was during the lockdowns and everything. It still carried on, thankfully. So I did have to wait quite a long time. I think I had to wait, well, really about a year or so to get my place. But, yeah, every week I'd go, she'd put the needle in my foot, start the machine going, and you can put the electric current that goes through, you can control how strong it is. So at first, the current I had to have was quite strong before I'd start feeling the tingling in my toes. When you've got it in the right place, it literally makes your toes scrunch up and it's involuntary, so it's like the electric point.

Helen

Does it hurt?

Sara

It doesn't hurt, but it can tingle. And after the session, sometimes it used to make my leg ache a little bit if I'd go walking straight after, but nothing bad at all. And she used to say to me, it's the nerve waking up, you're trying to wake that nerve up again. I didn't really notice any difference at all until about, I'd say about week four, week five, and after that it just got massively better. From there, I was leaking urine less and now I've finished the treatment completely, I don't leak poo at all anymore and it's just been completely life changing and I found that I was able to go out a lot more now. I'd had the leaking poo taken away and worrying about that, I was getting my confidence back. I think it was the mixture, really, of the PTNS, the counselling that I had, and then also I got fitted with a pessary. So the PTNS had helped, massively helped the bowel movement, leakage side of things, but I was noticing that I was still, when I was exercising and things like that, I was still leaking urine. So rather than them saying, no, that's it, you're not having anything else, they got me back in again and I went to see a Urogynaecologist who said, yes, we can do something to help with the stress incontinence side of things. And she fitted me with a pessary.

Helen

What kind of pessary have you got? I'm actually going for a fitting tomorrow.

Sara

Oh, are you? Okay. Yeah. It always makes me giggle and I know it's silly because it's called a ring pessary with knob. It's so immature, isn't it? But it really makes me giggle.

Helen

Wherever you can find your laughs, that's fine.

Sara

I know, but she was great. So I had it fitted and at first when I saw it, I was like, God, how is that going to work?

Helen

They are terrifying looking aren’t they?

Sara

Yeah! She fitted it in and she said, ‘right, okay, stand up’ and she said ‘Right, now cough’.  And I was like, obviously, it's not the most glamorous thing, you're standing there with no underwear on or whatever and I'm just thinking, I'm going to wee over her floor here. So she was like ‘It's fine, it's fine, don't worry about it’. So I coughed nothing at all, couldn't even feel it in at all. I can't feel it. And then she said ‘okay, try it now for a week’. And I went home and I did the school run. Nothing. Normally I wear a liner or a pad just to sort of be safe, but didn't wear anything. I thought, well, okay, I'll test it out and if I wet myself, I'm not too far from home, so it's not that much of a problem. So I did the school run and I literally came back to check and there was nothing at all and I was like, oh, my god, oh, my god. I rang my mum and then I went back again to see the same lady at Southend and she taught me how to take it out and put it back in again myself. And that has just given me so much more freedom now and flexibility, because I'm finding with a combination of everything with the PTNS side of things as well. I don't need to wear it every day. It's only if I'm doing more strenuous exercises, if I know I'm going to be out walking a lot, I'll put it in and it just gives me that freedom back again, to do normal things, just to have a normal life and do what I want with my children. So it's literally like I've done a complete 180 from how I was to how I am now. I just feel like I've got my life back, so I can't recommend it enough.

Helen

I'm so happy for you and you've done so well. Like you say, there was a point when you were just like, right, well, this is it, this is my life now. And look at all these things that you've grabbed with both hands, and you've done all that yourself. You've put the work in and you've been prepared to make these adaptations. And, yeah, all right, it's not fixed. You're not back to where you were before. But sometimes, well, you just got to take what you can get, haven't you?

Sara

And the Urogynaecologist I saw, actually, she said she feels that it needs to be spoken about on NCT courses and things like that. That basically your reproductive system. I can't even say it, but downstairs… It’s silly isn't it? That your vagina, all of that, it's not going to be the same. And I think I said to her, I just feel like everything's such a car crash down there, and she said ‘it's not, it is just the new… well how it is… and that is normal after having a baby.’ And I think once I accepted that in my mind, it became a lot easier to deal with and I stopped looking at it as a negative thing and actually, I'm able to see it now. I've given birth to two lovely children. My body has been through that. I'm proud of my body for doing that. And, yeah, it's unlucky that I had all the things afterwards, but I've been able to have these treatments, I've been able to get back to the point where I can now live my life, but I just want more people to know about it, really, and to not accept that that's your lot.

Helen

Yeah, 100%. What would you sort of have said to yourself, knowing what you know now, when it all verse kicked off for you, or what advice would you have for women who are in that position?

Sara

I think my first thing I'd probably say to myself is, actually, you're doing really well and it's not your fault. I spent such a long time feeling like I was a failure, that I had failed giving birth, I'd failed breastfeeding, and I was just so hard on myself. I just felt like I wasn't worth anything. I just felt broken, completely broken. Sorry. It's hard to talk about that side of things, but I think the main takeaway is to say, really that you are worth looking after. It is worth going to the doctors and pushing to get the right treatment. You are worthwhile and you deserve it. If you're not fully fighting fit and able to live your life, then you can't be there for your children, you can't be there for your partner, you can't be there for your friends. You don't deserve to lose yourself to this. And it's just that there is a light at the end of the tunnel. But you just have to keep pushing. Keep pushing for it and don't give up. That's definitely one of the big takeaways, really. There have been a lot of health professionals that I've seen over the years that have said, no, there's nothing we can do for you now. No, that won't work. That's it, basically. Always keep pushing, always say, is there someone else I could see? Is there anything else that can be done? Because there is, but you just have to be dogged about it.

Helen

Sara Duckett, if you're listening, thank you so much. I think you're amazing. I'll put a bit more information about PTNS in the show notes. We also mentioned biofeedback, so if pelvic floor tech is as confusing to you as it was for me, do listen back to the Vadgets episode from last season.  As ever, please don't take any of this as medical advice, but do seek out your own professional help.
Next week I'll be speaking to a colorectal surgeon to come back for that. In the meantime, get involved. Tell me what you think and spread the word. Tell a friend or spam a WhatsApp group. Put an advert on the side of a bus. You can support the podcast https://www.buymeacoffee.com/whymumsdontjump  And it can be completely anonymous if you prefer. Thanks to everyone who's done that. And you can find me on socials at Why Mums Don't Jump or https://whymumsdontjump.com/. Bye for now.