Jeannie
Jeannie is living with a prolapsed bladder, sometimes called an anterior prolapse, for about 10 years. For the last 8 years, she has used a ring pessary to manage her prolapse but is looking into trying a different type of pessary. Jeannie does not want to have surgery to repair her prolapse.
Jeannie is married and has two children. She works full-time in a nursery. Her ethnicity is White British.
Condition: pelvic organ prolapse
More about me...
Jeannie is married and has two adult children. She started to notice prolapse symptoms after she went through menopause after turning 50 years old. Jeannie felt a downward, dragging pressure like her insides were going to fall out but was not sure what was happening.
Jeannie saw her GP about this problem and was referred to a gynaecologist. The gynaecologist told her that she had a bladder prolapse and recommended a surgical repair. Jeannie was unprepared to hear this news and found it very upsetting. Jeannie really did not want to have surgery and asked for other options. The gynaecologist referred her to a physiotherapist. Jeannie really liked her physiotherapist. The female physiotherapist showed Jeannie how to do pelvic floor exercises and told Jeannie about vaginal pessaries. A pessary is placed into the vagina and left in to support the vaginal walls and pelvic organs. The gynaecologist never told Jeannie about these things.
Jeannie went to see her GP to ask about getting a vaginal pessary. Jeannie’s GP referred her to a nurse practitioner. The nurse practitioner was able to fit Jeannie for a ring pessary and instructed Jeannie to keep it in for six months before coming back for a replacement. Initially, Jeannie experienced some bleeding as her body got used to the ring pessary. She managed the bleeding by using a hormone cream twice a week. Jeannie began removing her ring pessary every night and her bleeding is now less frequent. Jeannie finds it impossible to do her day-to-day activities without the pessary. She needs to be very careful about lifting and cannot walk as far as she used to.
Jeannie still gets asked if she wants to have surgery to repair her prolapse. She does not like hospitals because of prior bad experiences and does not want surgery. Jeannie said that she is not in pain, is not incontinent, and does not see her condition as life threatening. So, she wants to exhaust all other options before considering surgery. But, even if she tries everything else, surgery still might not be right for her.
Recently, Jeannie feels that her prolapse has become worse. She feels like she’s prolapsing past her ring pessary and wants to see about getting a different size or shape of pessary. Jeannie knows there are many types of pessaries that she could try but has not found anyone who knows how to fit them. She is very frustrated trying to get answers about which ones might be better for her. Jeannie wishes there was a single place you could go and get all the answers about prolapse.
Jeannie is worried about her incontinence and feels angry that no one gave her the information that she needed earlier.
Jeannie is worried about her incontinence and feels angry that no one gave her the information that she needed earlier.
I was scared of becoming incontinent, and I was scared of sort of ending up being one of those sort of smelly old women on the bus, that everyone moves away from because I can’t manage my incontinence and I just didn’t know what was gonna happen with that. And I just felt, you know it, fear of the operation and fear that it wouldn’t go well and then you know I’d end up being in a worse position.
So, I spent a lot of time crying at that time. And then I think I got quite, I felt quite angry and I just felt of all the times that I’ve been to the doctors and had smears and you know after I’d had my second child, and going for sort of contraceptive advice, and everything, all the times that people had you know been looking, and no-one had said, no-one had said, ‘You know like there’s a problem here, and especially after menopause it might get a lot worse, so in a, be careful what you’re doing in your job, be careful about lifting, be careful, you know what you’re doing in your general life. You know go now to a physiotherapist and get the exercises, and, and get regular check-ups.’ Nobody says it, nobody said a word. I felt really, I still, still feeling tearful now because I feel so annoyed that you know that there was nothing, nobody mentioned anything. But I just, it’s just unbelievable really.
When Jeannie first had a ring pessary (a plastic or silicone device inserted into the vagina to support the tissues), she had bleeding and discharge which she says “doesn’t make you feel very sexy at all”.
When Jeannie first had a ring pessary (a plastic or silicone device inserted into the vagina to support the tissues), she had bleeding and discharge which she says “doesn’t make you feel very sexy at all”.
And I think when I was first-, you know, when I was first diagnosed and I was first using the ring pessary, from that time, for about five years we didn’t have sex at all. And that was partly because, I think after the menopause I just wasn’t that interested anyway, partly that. I think, with the ring pessary, I didn’t know that you could get a lot of discharge from I think just having a foreign body inside, and also, I had some bleeding from abrasions caused by the ring so then I was using creams to stop the bleeding, like hormone creams. But none of that stuff makes you feel really like having sex, you know, it doesn’t make you feel very sexy at all.
Jeannie likes to be out in nature. She can walk for a few miles before her prolapse becomes too uncomfortable. She enjoys gardening too, but has to be careful.
Jeannie likes to be out in nature. She can walk for a few miles before her prolapse becomes too uncomfortable. She enjoys gardening too, but has to be careful.
I’ve never been like a really sporty person but I do like going for walks in the countryside and birdwatching and that kind of thing, but I can’t walk now as far as I used to be able, maybe I can do two or three miles, no, three or four miles comfortably. Anything more than that and it starts to get quite uncomfortable and I feel like I need to, you know at least have a long rest or lie down for a bit, or something like that. So it’s changed what I’m able to do and what I’m able to enjoy.
Things like gardening I find quite difficult, which is really frustrating ‘cos I love gardening but every time I…you know like at times when I feel that I’ve made things worse it’s always been when I’ve just been trying to move a flowerpot or something like that, so I have to be really, really careful with anything that involves any lifting.
Jeannie had a ring pessary fitted by the nurse in her general practice. She says “it was a lifesaver because it made such a difference”.
Jeannie had a ring pessary fitted by the nurse in her general practice. She says “it was a lifesaver because it made such a difference”.
I went to the nurse with an appointment to get a ring pessary fitted. I think I’d googled it to see what it looks like roughly and it is just it’s just a ring, it’s like a curtain ring or something like that. And so it was like any other kind of examination that I’ve had loads of times with having two children, and you know or having a smear test or something like that. And she just showed me the pessary, and she said that she was going to fit it in, and it was just very quick really. She said it might feel, I might be able to feel it a little bit the first you know at first, maybe the first day or something like that, but I’d get used to it, and I shouldn’t be able to feel it. She said if there was any pain or any problems with it to come straight back. It was very quick and easy appointment actually. Yeah. Yeah, not really any problems and I think I had to come back a week later to make sure that it was okay, so I did that and she, yeah that was fine. And then she said to come back in six months, and so every six months I go back and she gives me a different one. And at first she wanted me to just leave it in for the six months, but after I’d said that I wasn’t leaving it in, I was taking it out at night and putting it back in in the morning, she sort of gave me tips like if you, if you can twist it into a sort of figure of eight shape it’s a bit easier to get it in. Sort of you kind of twist it, because it’s tricky at first, I mean now it’s absolutely no problem whatsoever I can take it in and out with absolutely no trouble. At first it just feels like this big thing, it’s a bit weird but yeah, you kind of quite soon get used to it. Yeah and it’s a lifesaver really, because it made such a difference.
Jeannie felt that her NHS physiotherapist listened well and took the time to understand her needs.
Jeannie felt that her NHS physiotherapist listened well and took the time to understand her needs.
I think the best time was when I went to see the physiotherapist. Because I felt like she really understood me, that she listened to what I was saying. And she asked me lots of questions, you know relevant questions, and she gave me lots of information and she answered all my questions. And she, I felt like she, she was sort of on the same wavelength in that she didn’t want to talk about the sort of drastic, you know like she wasn’t talking about starting with operations, she was sort of about the, the, starting with pelvic floor exercises and then you know going on from there, starting with just me being able to help myself but then if that doesn’t work then there’s this we can try and that we can try, you know. And being operated on was a very last resort which was exactly how I was feeling as well.
So that was really good, I just felt she had a really good understanding of my difficulties, and she was very positive about what could be done, and she also, it wasn’t just a one-off appointment, she said, you know, come back and if you’ve got more questions, ‘cos the first time you, you know when you ask loads of questions and then you go away and then quite often you think, ‘Oh why didn’t I ask this or that?,’ you know. So it’s always good to go back and, and also she gave me loads of exercises to do and it’s good to go back and know that you’re doing them properly and that, see if there’s been any improvement or not, and just to have, that just felt like proper care, it felt like you know it was, it felt hopeful and encouraging and it felt like it was more of a two-way conversation than just me being told what I should do, or what’s gonna happen or something like that.
Jeannie got the impression that the specialist thought she should have surgery and was “being a bit silly” to have reservations.
Jeannie got the impression that the specialist thought she should have surgery and was “being a bit silly” to have reservations.
And the gynaecologist did an examination and said that there was a lot of laxity and we could sort this out with a small operation and I sort of burst into tears, and said that I really didn’t want an operation and isn’t there anything else, you know, that I could do. And he was a little bit [pause] I just felt that he thought I was being, just being a bit silly really, but he’s sort of said, “Well I’ll refer you to the physiotherapist and go and see her and you know see what she says, and then come back in a few months, and you know maybe you’ll have changed your mind.”
When Jeannie self-referred to a physiotherapist for sciatic nerve pain, she mentioned that she has prolapse. Between the gynaecologist and physiotherapist, she hopes to get more support; if not, she plans to explore private healthcare options.
When Jeannie self-referred to a physiotherapist for sciatic nerve pain, she mentioned that she has prolapse. Between the gynaecologist and physiotherapist, she hopes to get more support; if not, she plans to explore private healthcare options.
So, I think I’m going to go to these, this gynaecology appointment and see what happens then. I’ve also been referred, it was really, I got a referral for my sciatica to a physiotherapist, well the GP told me to self-refer to a physiotherapist about my sciatica, and when I self-referred on the form, I said, “Can that physiotherapist bear in mind that I have a prolapse, and not give me exercises to do that will actually make my prolapse worse,” because that’s happened in the past as well. And so actually the person who phoned me up was a physiotherapist that deals with prolapses, she, she sees people, that’s her job is to see people with, you know with those kind of problems. Yeah, so I’m hoping that going back to that physiotherapist will help and I’ve, I’ve spoken to her, yeah, I’ve had an online, sorry a telephone meeting with her, but I’m going to see her in person at the end of this week. She doesn’t fit pessaries, huh, but I’m hoping that you know maybe there’s something that she can help me with, physio-wise, and maybe the gynaecologist will be able to help me pessary wise, but if neither of those things turn out well then I’ll have to try private.