Mary X

Age at interview: 74
Brief Outline:

Mary X has a prolapse that is well managed with a ring pessary and regular oestrogen pessaries. Mary X also had urinary incontinence which she manages by regularly emptying her bladder and using pads when necessary.

Background:

Mary X is a retired NHS psychiatrist. She lives with her husband and has two grown up children. She describes herself as White British.

Conditions: pelvic organ prolapse, urinary incontinence

More about me...

Mary X describes her urinary leakage as “perfectly manageable”. She tends to be “a bit careful” and does not let her bladder get full. She also wears pads when she feels that she needs to and might have to think ahead about where the toilet is if she is going out.

More recently, Mary X noticed a slight prolapse and went to the doctor to get this diagnosis confirmed. She tried various ring pessaries which all “popped straight out” until she had the right size fitted by a gynaecology consultant. At this point, she was very relieved to be told that she did not need surgery. Mary X feels it would have been useful to see a consultant earlier in order to avoid some of this worry. Mary X has also seen a physiotherapist who suggested a regime of pelvic floor exercises and electrical stimulation: she is not convinced that this has really made a lot of difference.

Mary X feels lucky to have a good relationship with her GP who listens, discusses and negotiates with her about treatment decisions. Mary X also has a close circle of friends and feels it is good to be able to talk to someone else about the effects of her prolapse and incontinence. She remains positive and is happy to share a joke with her friends about it all.

Mary X feels that it would be useful for the public to know how many people live with prolapse and incontinence. She feels that there should always be public toilets available, and that pads should be free to those who cannot afford them. Mary X has noticed that although the public attitude to disability is much more positive than it was when she was younger, incontinence is still stigmatised and regarded as a sign of old age.

Mary X stopped jogging but finds cycling is okay and thinks that sitting on a saddle stops her from having urinary leaks.

Mary X stopped jogging but finds cycling is okay and thinks that sitting on a saddle stops her from having urinary leaks.

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The only this is, I suppose it stopped me jogging because I found that if I jogged then I would wet myself. So that, not a big deal, I wasn’t that keen on jogging in the first place. And all it does is mess up your knees anyway, doesn’t it? So yeah, I mean running I suppose, on, on a full bladder is a bit of problem sometimes. But then it doesn’t really matter because if I’m going to do, run, like when I run on my running machine, then I just empty my bladder first and I suppose it makes cycling easier ‘cos you know you’re okay on a bike. It sort of seals it off as long as you sit on the saddle fairly tightly.

 

Mary X was loaned a pelvic floor trainer by her physiotherapist. After testing it out, she chose not to buy one for herself one because she wasn’t sure it worked.

Mary X was loaned a pelvic floor trainer by her physiotherapist. After testing it out, she chose not to buy one for herself one because she wasn’t sure it worked.

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She, so, so she gave me lots of exercises and then she said to try this electronic device that stimulates your, you can buy them online but they, they hire, they loan them to you. And so I used to have to put that in every day, I think. And you had to let it pulse for so many times. I can’t remember how it all worked now, but it was, it was quite easy to do, and it was meant to stimulate your muscles and she felt that it would then, I would recognise what to do in future in terms of using those muscles because I’d feel them being stimulated. So we did that, and then, and I thought, ‘Shall I buy one?’ And I thought, no, I won’t bother because I wasn’t entirely convinced it made any difference, I really don’t know. You don’t really know whether these things made difference but you, you think it’s worth a try.

 

Mary X has open and informed discussions with her GP about treatment options.

Mary X has open and informed discussions with her GP about treatment options.

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So I mean I went with a sort of list of things that I might do, like physio or, or pessaries or have an operation, cos I’d read up about it. And as I said, if, my GP’s nice cos he’ll, he sort of says, “Well, you know what do you want to do?” And I say, “Well you know, what’s on offer, what’s available?” And he will say, “Well you can, you know you can try this, or you can try that.” He very much wanted me not, I mean they try and avoid referring to the gynae, I think he, he feels they’ve got a good practice and they could probably deal with it within the practice. And if the pessaries had stayed in, then I probably wouldn’t have got as far as the gynae people, because I’d have been under their nurse and the GP. I probably wouldn’t have had the oestradiol. I think we discussed, I discussed that with him and he said, “Well do you think it would work?” And I said, “I don’t know, do you think it would work?” He said, “I’ve no idea, but I don’t expect so.” So, I said, “Well we’ll leave that one.” And it wasn’t until the physio recommended it that he prescribed that. But then he was quite happy to prescribe it. So yeah, it, as I say I probably did have a sort of agenda, but it wasn’t a very fixed one, quite happy if he’s sort of suggested something else.

 

Mary X thinks it is important for doctors to see patients as a “whole person” rather than within the confines of a medical specialty.

Mary X thinks it is important for doctors to see patients as a “whole person” rather than within the confines of a medical specialty.

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I suppose it is sort of seeing the person as a whole person, and what I think is difficult is that people think in specialities so that they don’t recognise that people have more than one, or quite often certainly when they, as they get older particularly, but generally often have more than one thing. So, they just focus on the thing that’s, that they see as their province, and don’t take into account the other things. And it’s, it’s having a more holistic view of people I suppose.