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POP Journal: Catching Up

Quick recap for those of you who are just tuning in: I was diagnosed with bladder prolapse when my little one was about 8 months old. I went to pelvic floor physical therapy and it changed my life. No joke, no exaggeration. That was a little over two years ago, and while it certainly hasn't been a direct route, I can now run, lift weights, and basically do all the things that websites about prolapse tell you not to do, with no symptoms. I've squatted 210 lbs, deadlifted 260, and my prolapse is no worse for the wear. 

(Your mileage may vary. This should in no way be considered medical advice and you should talk to a pelvic floor physical therapist before doing those things.)

What I haven't talked about is that I had to take a big step back in January of this year. Last summer and through the fall I felt amazing. No symptoms. Felt strong as hell. Give me all the things and I will pick them up and put them down. Got a phone book handy? I'll tear that mf-er in half. 

I was feeling so great that I decided to register for a powerlifting meet that would take place in January. Not to COMPETE, just to do it and hopefully set some personal bests. 

Have you seen anything about a powerlifting meet on this blog or on Facebook? No? No. Why? I didn't do it. 

About a month before the meet, I did something. I'm pretty sure it was holding the bottom position of a back squat that did it, and my pelvic floor was all NOPE. I called the workout for the day and left the gym almost in tears.

I was sure that I'd gone too far, pushed too hard, made everything worse and now I'd need surgery and how can I train women with POP when I can't even manage my own and what have I done oh god oh god OH GOD.

I went back to my pelvic floor physical therapist who checked me and said that she didn't think anything was different. I still had the one prolapse (I was convinced I'd also given myself a rectocele -- when the back wall of the vagina falls forward -- in addition to making my existing prolapse worse). She told me she didn't see any reason why I couldn't continue with my heavy lifting.

But I couldn't. Mentally, I just couldn't. I was terrified. 

If you have POP, you know what I'm talking about. You're afraid to move, afraid to pick anything up, unable to live your life for fear of making your prolapse worse. Because that's the worst case scenario and once those supportive ligaments have been pushed too far and they just give up, they don't go back. There is no cure. You either live with it or you get surgery, and the failure rate is about 30%.

How do you like them apples? Not well, actually, not well at all.

I talked about it with my trainer. He's a fantastic coach and defers to me when I say nope, my pelvic floor is not ok with that exercise right now. And yes, I do have those conversations in those exact words. You don't necessarily have to be that blunt, but your trainers, coaches, and instructors have to know what's going on. 

We dialed everything back effective right that second. Cut out all squats. Cut out everything heavy. Pivoted to low weight/high rep stuff while I monitored my strategy. Was I breathing? Was I thrusting my ribs? Was I clenching my pelvic floor because relaxing it felt scary? Actually, yeah. 

It's been almost five months since then and I've made enormous progress. We've added sprinting to my workouts, and that feels great. No heaviness or pressure and no pelvic floor problems during or after, always being careful of my strategy. I've recently started back squatting again, keeping the weight to less than half of what my max was before and deciding on a set-by-set basis how much to do that day. 

The hardest part of all of this is my pride. If I go to special events that my gym hosts and everyone else is testing their lifts, I'm not going to do that. Could I? Sure. Should I? Nope. The whole risk vs. reward question becomes a lot clearer when you're talking about irreparable damage and you're able to put your ego aside. 

I still feel strong. I still feel great about my workouts, and I'm not just lying on the floor doing clamshells and kegels for an hour. 

Every so often someone who knew I was registered for the meet asks me about it. I'm very open and tell them that my pelvic floor just wasn't ready, and I needed to take a step back. They always ask if I'll do one in the future, and the honest answer is that I don't know.

I might have maxed out on my big lifts and never PR again. I might never do a powerlifting meet. 

Can I live a happy and healthy life without any more PRs or powerlifting? Yes. Am I sad that that's a possibility? Yes. 

Most women, myself included, feel a very real grief after their POP diagnosis. It's not something that you "get over," though, because there's a constant recalibration of what works for you and what doesn't. That can and does change even from day to day. There's a lot of hope, especially for those who are diagnosed soon after having a baby. So much healing occurs during the first year, and even beyond, especially for breastfeeding moms, so I hope this doesn't come across as EVERYTHING IS AWFUL AND YOUR LIFE IS RUINED, because it's not. There have actually been a lot of positive changes in my life as a direct result of my prolapse, believe it or not, but that's a post for another time. 

Prolapse can feel so isolating, and it's invisible to well-meaning strangers, friends, and relatives. You wouldn't tell someone with a cast on their leg to go for a run; there's no such marker for prolapse. I will talk about my pelvic floor with literally anyone, but most women aren't quite so comfortable - and that's ok! So how do you explain to your friend that you can't go for a run with her when you look fine? What do you tell people at the gym when they want to know why you're not lifting heavy anymore, when it was going so well? 

Every time a conversation like that happens a fresh wave of grief, anger, and bitterness sweeps over me. Sometimes it's just a ripple that passes through my mind and then it's gone and I'm fine. Other times it crashes into me and drags me down to the depths where I just want to scream THIS IS NOT FUCKING FAIR.

Because that's the hardest part. You can do everything "right" and still get prolapse. You can do everything "wrong" and be totally fine. But at the end of the day, if you have POP, you have it. Trying to dissect the causes and pinpoint exactly what caused it is unproductive, yet we still do it. You can get to the point where you're totally or almost completely asymptomatic -- that's me, most days -- but your awareness of it is always there to some extent.

And that's what I grieve -- the ability to take my pelvic floor for granted.