The Most Basic Advice

If any doctor or specialist diagnoses you with any one prolapse (bladder, rectal, vaginal), it is critical that you not allow a single prolapse repair. First find an ob/gyn who is experienced in evaluating and treating pelvic prolapse (which views the entire condition of the pelvic organs).

If the single prolapse is due to a weakened pelvic floor condition or another pelvic issue, other organs may be impacted and the surgery may lead to the next prolapse. A trained ob/gyn will decide in which order the prolapse(s) needs to be repaired. Having a single repair and then learning of the pelvic prolapse can cause complications.

It's your body. Take charge and get a second opinion from a board certified ob/gyn who has adopted viewing any organ prolapse as potentially pelvic prolapse.


Colo-Rectal Repair to Bladder Therapy

To say I was devastated when I discovered a rectal prolapse less than six months following the surgical repair which led to my requiring a blood transfusion was an understatement. I had the transfusion, abscess, and now a complete failure of the surgery itself. My body was exhausted, my emotions depleted, and the correct surgery was definitely major surgery.

It was in-hospital with a five-day stay. The incision went from belly button to bikini line. I don't recall the exact medical steps but it was basically pulling the rectum up. I was told some of my colon might have to be removed and a very small part of it only, thank goodness, had to be excised. A mesh sling holds my colon up so it doesn't place pressure on the rectum.  In preparation for the surgery, Dr. McKenna recommended an epidural for pain. I had always been terrified of anything going into my spine.

The day of my pre-admission testing and consultation, I argued ardently against it. The anesthesiologist said the pain would likely be unbearable without it. I relented and signed the release. The morning of surgery I was terrified of the epidural because it had to be done while I was wide awake. I was taken to a room where I was surrounded by good looking young interns. lol. One person reassuringly held onto me and told me everything that was going on. Honestly, there was no pain. I was so relieved to hear "it's in". Apparently having an epidural was a procedure not often viewed by interns or they had a new class but I had plenty of reassuring looks and hand holding.

Following surgery and for the next four days, I was amazingly pain free. The wire had actually just come loose and I was feeling around for it when Dr. McKenna's team came in for their daily rounds. They said they were there to see if the epidural line should be removed. When I said I thought it had just come out they said that was highly unlikely and the team leader went behind me. He held up the wire that had indeed come loose and announced, "The epidural is officially removed." Another lol.

A morphine drip was hooked up immediately. From no pain to OMG pain in a matter of hours. I requested oral painkillers about six hours later because the morphine seemed to do nothing. Pain was manageable with the oxycodone or hydrocodone, whichever they gave me, and I was released on Day 5.

After several follow up visits, I realized there was still some weirdness which turned out to be a mucosal prolapse. Dr. McKenna had warned me that, because of what Dr. DeLeo had done, he wasn't able to guarantee the outcome. Had he been the first to repair it correctly, he could have pretty much guaranteed there would be no more prolapses. This secondary prolapse was not as large and was manageable. While the doctor had described what he could do to "fix" it, he must have been having a bad day because it was something he would have done in his office without anesthesia. He stated it rather gruffly leaving me to believe I was a pain in his *ss. I was not going to have anything to do with a repair without anesthesia. I hoped exercise over time might tighten the muscles and lift it naturally. It did create pressure from the inside; however that didn't become as noticeable until after my bladder therapy.

While I was urinating up to 20 times a day, I kept being advised the bladder would have to be the last of the three orifices to be addressed. Finally I was referred to the bladder specialist.

P.S. More to come about Dr. McKenna and repair of the mucosal prolapse. He became very caring and respectful with help from my family doctor. Dr. McKenna was, to me, like Dr. House. The best bedside manner. I wouldn't have wanted anyone else doing the repair.


Hysterectomy to Mayhem

While an awful topic to address, I believe it is necessary because it might save someone else from having the same problem when it would have been so easy to stop. Since the time of my abscess, I had virtually non-stop, uncontrollable bowel movements. It was such a horrid time. As much as anyone hates to think of ever wearing Depends, I have to say they never let me down even though I froze in horror on so many occasions.

I became a recluse except for doctor appointments. I had gone into my ob/gyn appointment with that problem but Dr. Harkins said the main issue was to do the hysterectomy which might resolve the problem. It didn't. After several follow ups to the hysterectomy and no resolution to the bowel problem, I was referred to a gastroenterologist. He took one look at my medication list and immediately took me off two medications, each prescribed by Drs. McKenna and Harkins.

My body responds differently to most medications than one would expect. I was being monitored so closely but no one was monitoring the meds. Two were to prevent constipation and, at that time, I just did what I was told.  The great lesson here is to be your own advocate and ask about medications if your body is not doing what it is supposed to and no one seems to know why. I lived with that awful problem from early September 2007 until January 2008. I was simply in survival mode and really not thinking about one moment to the next. Hopefully anyone reading this will think to ask if you find yourself in a similar situation. Medications can cause very unusual body responses.

Within two days of following the gastroenterologist's advice, I was back at a more manageable level. No more Depends but needing the bathroom 10 or more times a day. I had a special diet that also helped. It was January 2008. I tried returning to work in February with clients understanding I might need a mid-session break which I hated to do.  But I was back at work.

Later in February,  I was accompanying a client to a meeting as her advocate. When I stopped in the restroom on arriving, I saw my rectal prolapse had returned with full force. Dr. DeLeo had "repaired" it in my near death surgery only six months earlier. I was once again devastated.

Returning to Dr. McKenna, he informed me that the previous surgeon had used the incorrect method of repair for my age and level of activiy (prior to the prolapses). He scheduled me for a colorectoplexy, abdominal surgery to repair the rectal wall and possibly remove a portion of my colon.

I tried to return to work until just before the surgery but my emotions were in meltdown and I could no longer keep my focus on my clients. My life as I knew it was changing.


The Missing Cyst

In August 2007 I had surgery to remove an ovarian cyst but was told post-surgery that no cyst could be found. The surgeon proceeded with the next surgery a few weeks later...see previous post. At the point Dr. McKenna casually mentioned "except for the cyst on your ovary", I felt so many feelings flood me at once. Shock, betrayal, fear. What had I allowed this incompentent doctor to do to me.

Dr. McKenna was kind to refer me to the head of Micro-Invasive Surgery in the Hershey Medical Center ob/gyn department. Dr. Harkins thought death had walked into the room when I arrived at his office. He ordered the correct imaging to see what was going on. He identified several issues from the test in addition to everything that had been identified in the previous analysis sent to Dr. DeLeo.

Dr. Harkins recommended a hysterectomy as he believed that particular issue should have been done first and may have avoided the other two prolapses. Hindsight is everything. In October 2007, the hysterectomy was performed. We had decided ahead of time to keep my right ovary if it was viable. He planned to remove the fallopian tubes, the left ovary and the cyst. However, he told me post-surgery, that he could see right away through the laparoscopy scope that I had a "frozen pelvis".

A "frozen pelvis" is when endometriosis has wrapped itself in and around the uterus as well as organs outside of the uterus. I was a mess. He spent a long time removing the endometriosis and found beneath it a healthy pink right ovary. There was no way a trained surgeon could possibly have missed what he found. Dr. Harkins showed me the video of his procedure. I was stunned. Thank goodness I was led to him. The irony is I was terrified of a male ob/gyn yet it was a women who caused harm and a male who saved me.


Connecting the Missing Dots

It has been so long since I've kept this blog up to date. I reread my posts and realized there is a blank ending at the end of the 12/22/08 post where Dr. DeLeo had read my MRI, informed me of an ovarian cyst, and scheduled a laparoscopy to remove the cyst followed several weeks later by the rectocele.

When I awoke from the laparoscopy, she informed me there had been no cyst but she "cleaned things up" and I would be fine. All okay for the next surgery. In retrospect, Brian would say she viewed me as her "cash cow".  In my earlier post I explained what happened following her rectocele. I was hospitalized requiring a transfusion due to hemorrhaging during surgery. A week after surviving that ordeal, I experienced a rectal abscess.

Brian had called Dr. DeLeo's office a week after the botched up rectocele. I had already made the decision to take myself out of her care but Brian thought she was the one who needed to determine if what I was experiencing was a post surgery issue. All I can say is that I had painful burning. Her office told me I was to do nothing. Later that day, the burning had intensified to where I was crying. I called the Penn State Medicine after hours nurse triage line. They told me to go to the emergency room right away and they would call ahead to say I was coming.

I had only a half-hour wait in a packed waiting room. Via CT scan, an abscess was identified. A drain had to be put into my back and I was in the hospital about five days with no food. I had to return home with the drain still in my back. I was a physical and emotional mess. The drain was finally removed and I had a follow up appointment with the doctor in charge of the colo-rectal department, Dr. McKenna. By that time I was so fearful of the previous surgeries handled by Dr. DeLeo. I asked Dr. McKenna if everything else looked okay in my pelvic area.

He replied it looked okay except for a cyst on my ovary.

To be continued in next post.