HELP

Hi

SPD is symphysis pubis dsyfunction - it causes extreme pain in the
groin (feels like you've been kicked in the groin by a donkey). The
bones at the front of the pelvis begin to part, they think due to the
hormone relaxin but most things are caused by a combination of factors.
Thanks for coming back to me on this - I always think 'positive' but
its nice when others share their experiences and show that despite it
all vaginal birth is perfectly possible.

Lots of love

Sue
Engram wrote:
"sue the doula" wrote in message
oups.com...
Hi - my name is Sue, I work as a doula, (www.kentdoulas.co.uk) getting
amazing births for amazing women - my latest client has just suffered a
prolapsed disc (with a touch of SPD) - anyone had any personal
experience of this?

Many thanks

Sue
ps. look at my website and let me know if I've missed anything - check
out the links - are they working properly for you?

I have prolapsed discs (L5/S1 and L4/5) with a compressed right L5 root and
probable compromise of the left L4 root. What anyone can tell you about
coping with pregnancy with prolapsed discs will depend on whether your
client's injury is in a similar site and of similar severity. However, I
will attempt to answer any questions you may have to the best of my ability.
For what it's worth, with my first pregnancy I only had the L5/S1 prolapse
with no nerve root compromise and went through a normal vaginal birth, the
prolapse did not affect anything. The rest of the problems developed as a
result of the pregnancy. This time around an anaesthetist/anesthesiologist
(depending on where you're from) wanted to make me have a caesarian but was
over-ruled by a neurosurgeon who said that there is nothing in the location
and severity of my prolapse to counter-indicate a vaginal birth and that I
can have an epidural if I want one (still undecided on that one).

Also, what is SPD? I keep hearing people mention it but the only thing I
could find is Spondyloperipheral dysplasia, which is a genetic disorder and
thus people would not be "developing it" but would have been born with it...
Birth junkie mentioned her SPD causing pubic pain - something, which I, too,
have been experiencing this pregnancy but have no idea of what is causing it
(I do not have the dysplasia mentioned above, my bone growth is normal).

Engram

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Matthew 21 June 2005
DD EDD 06 Oct 2006

Check out our family at
http://www.geocities.com/engram_au/

sue the doula wrote:
Hi

SPD is symphysis pubis dsyfunction - it causes extreme pain in the
groin (feels like you've been kicked in the groin by a donkey). The
bones at the front of the pelvis begin to part, they think due to the
hormone relaxin but most things are caused by a combination of factors.
Thanks for coming back to me on this - I always think 'positive' but
its nice when others share their experiences and show that despite it
all vaginal birth is perfectly possible.

Lots of love

Sue
Engram wrote:
"sue the doula" wrote in message
oups.com...
Hi - my name is Sue, I work as a doula, (www.kentdoulas.co.uk) getting
amazing births for amazing women - my latest client has just suffered a
prolapsed disc (with a touch of SPD) - anyone had any personal
experience of this?

Many thanks

Sue
ps. look at my website and let me know if I've missed anything - check
out the links - are they working properly for you?
I have prolapsed discs (L5/S1 and L4/5) with a compressed right L5 root and
probable compromise of the left L4 root. What anyone can tell you about
coping with pregnancy with prolapsed discs will depend on whether your
client's injury is in a similar site and of similar severity. However, I
will attempt to answer any questions you may have to the best of my ability.
For what it's worth, with my first pregnancy I only had the L5/S1 prolapse
with no nerve root compromise and went through a normal vaginal birth, the
prolapse did not affect anything. The rest of the problems developed as a
result of the pregnancy. This time around an anaesthetist/anesthesiologist
(depending on where you're from) wanted to make me have a caesarian but was
over-ruled by a neurosurgeon who said that there is nothing in the location
and severity of my prolapse to counter-indicate a vaginal birth and that I
can have an epidural if I want one (still undecided on that one).

Also, what is SPD? I keep hearing people mention it but the only thing I
could find is Spondyloperipheral dysplasia, which is a genetic disorder and
thus people would not be "developing it" but would have been born with it...
Birth junkie mentioned her SPD causing pubic pain - something, which I, too,
have been experiencing this pregnancy but have no idea of what is causing it
(I do not have the dysplasia mentioned above, my bone growth is normal).

Engram

+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-
Matthew 21 June 2005
DD EDD 06 Oct 2006

Check out our family at
http://www.geocities.com/engram_au/



SPD also affects all joints of the pelvis. I experience great pain in
the sacro-illiac joint which is the joint that attaches the rear pelvic
bone to the spine. The pain can range from mild discomfort (oh ouch) to
extreme and acute (oh my god, I cant stand it). I have been on crutches
for several months now and wear a pregnancy support belt whenever
practical. I cannot walk more than a few hundred yards even with both
the belt and crutches as I experience extreme pain radiating from the
sacro-illiac all the way down my leg to the heal. This is NOT the same
as sciatica which is something else entirely. Far too often, SPD is
diagnosed by the inexperienced as sciatica which is in fact pretty rare
in pregnancy. I was much relieved the other week when during a routine
visit to the midwife, the locum midwife observed me walking and said
"ahh, you've got SPD havnt you dear". Most doctors seem to dismiss it as
inflammation of the ligaments caused by pregnancy hormones and that's
that. Probably because most of them are men and have no idea what it
actually feels like. Probably though, if you only experience the 'oh
ouch' pain rather than the 'oh my god' pain then you may well have just
a little bit of stretching. The 'oh my god' pain is caused by the bones
grating or moving out of sequence with the rest of the pelvis due to a
larger than normal gap between them. The gap in the sacro-illiac should
be about 4mm. In me, its 10mm, this means that all the pelvic bones move
independantly and wobble out of line which produces the grating and the
pain. I have been prescribed NSAIDS for the remainder of the pregnancy
and it usually takes several tablets to get me moving in the mornings.
If I overdo it and try to walk too far, I end up bedridden for the next
day and probably the day after. Its simply too painful to move.

Wookie

Wookie, I'm cringing at the memories of the "oh my god" pain you
describe. That's exactly what it was like for me with my twin
pregnancy. When I'd stand up, everything would "POP" and then I could
begin my *shuffle*. I could not get in/out of bed (slept in a recliner
for 3 weeks) and I couldn't put clothes on alone. It was quite
debilitating. There was one day I sat on the floor with my 2-yr-old to
play, and could not get up. My legs, pelvis simply would not work. I
had to sit there for an hour until my husband got home to help me off
the floor (reminds me of that commercial, "I've fallen and I can't get
up", except I'm not 80, LOL).

Hugs,
Lisa

birth junkie wrote:
Wookie, I'm cringing at the memories of the "oh my god" pain you
describe. That's exactly what it was like for me with my twin
pregnancy. When I'd stand up, everything would "POP" and then I could
begin my *shuffle*. I could not get in/out of bed (slept in a recliner
for 3 weeks) and I couldn't put clothes on alone. It was quite
debilitating. There was one day I sat on the floor with my 2-yr-old to
play, and could not get up. My legs, pelvis simply would not work. I
had to sit there for an hour until my husband got home to help me off
the floor (reminds me of that commercial, "I've fallen and I can't get
up", except I'm not 80, LOL).

Hugs,
Lisa



Oh yes. I have had several episodes of that particular hell.
Occasionally my pelvis is so mis-aligned when I stand that it literally
will not work and I cannot move either leg. I have to make a conscious
effort now to align the pelvis properly and ensure that both legs are
parallel before attempting to take a step. Unfortunately, I have added
complications concerning both knees due to a childhood accident which
just exacerbates the problem. Essentially, I dare not sit on the floor
at all because I simply cannot get back up again, I know this and make
allowances but it still does not mitigate the frustration I experience
when my body betrays me. At the moment, I have about 6 weeks to go and
this condition is deteriorating by the day almost. A few weeks ago, I
had the misfortune to trip over some toy of my daughters (I think it was
a jack in the box), one leg worked, and I jumped over it rather than
step on it which would have upended me, but the other leg refused to
work and did not come with the rest of my body. There was a sickening
(literally) crunch/pop in the sacro-illiac joint and I ended up on all
fours on the floor whimpering. I couldnt walk for days after that and my
ever loving husband had to help me with most everything regardless of
intimacy. I felt like an old woman and still do. The Physio tells me
that there is a good chance they can do something to rectify this
situation after the baby is born, but at the very least, given NHS
waiting times, I am looking at another year of this. My work colleagues
have been very understanding but it wasnt until my boss found me on the
floor of the ladies crying that she really took it to heart.

For a young fit (well, I WAS) woman of 28 this is so debilitating and to
find that the majority of medical personnel treat you as a hypochondriac
is almost soul destroying. After the tripping episode, the pain was so
acute, I went to our local A&E in the hope that they could do something,
anything to relieve the discomfort. I had a note from my doctor (GP) who
had sent me there and I explained the situation to the triage nurse. He
seemed to think that I was making it up and quoted a waiting time
(sitting on a wooden chair) of 4 hours to see a doctor. It wasnt until
he went away and read the note that he realised I was even pregnant and
that this could be a little more serious than he thought. Even so, the
doctor saw me, tutted a little, said it was quite normal and sent me off
again. It took a GP, the intervention of a midwife and 20 minutes of
begging for them to write me a prescription for something stronger than
paracetamol.


I have a 6ft long bean bag at home and I have taken to sleeping on that
now as laying in a normal bed puts too much pressure on the sacro-iliac
joint. The bend at the base of my spine is just too pronounced to be
able to get into a comfortable position in a normal bed even with the
aid of a feather mattress cover. My husband is understanding but I see
the frustration in his eyes sometimes when I cant do something I
previously used to be able to do (namely what husbands and wives do at
night that doesnt involve sleeping :-), or something I used to take for
granted such as walking around a supermarket. Not that I ever did enjoy
shopping, but since I have been forced to forgo this activity, I realise
just how disabled I have become and it frightens me sometimes. SPD is a
very real condition and should be taken seriously by the medical
profession at large but sadly it is not. Most doctors are still of the
male persuasion and with the best will in the world, they are just never
going to experience it. The biology of the male pelvis precludes this
type of situation for them. If I understood the Physio properly, all
four bones are semi-independent in a female but are not in a male.

Anyway, I've moaned enough.

Wookie

I think she's in the middle of an international move. Try her next week....

"Nina Pretty Ballerina" wrote in message
u...
Anne Rogers???


"sue the doula" wrote in message
oups.com...
Hi - my name is Sue, I work as a doula, (www.kentdoulas.co.uk) getting
amazing births for amazing women - my latest client has just suffered a
prolapsed disc (with a touch of SPD) - anyone had any personal
experience of this?

Many thanks

Sue
ps. look at my website and let me know if I've missed anything - check
out the links - are they working properly for you?

If I DO have SPD, I don't want to have to go through the same ordeal one
of the other NG members (was it Anne?) has had to go through because the
diagnosis kind of "slipped through" and people din't take appropriate care
at the time of delivery.

yes it was me, but it was really a communication issue rather than a
diagnosis issue, SPD was diagnosed by physio and midwife, but as things were
so bad I was seen by a rheumatologist, he was not clearly asked to diagnose
or exclude SPD, and didn't do an examination that could have led to a
conclusion either way, so didn't put it in his report, the OBs then read the
report and treated the lack of mention as it being excluded, that alone
wouldn't have made much difference. Given it was written in my notes by the
physio, I suspect that the midwifes caring for me at the time of delivery
were working with the diagnosis of SPD, just badly, the fact that if the
rheumatologist had got his other diagnoses correct I'd have not even been in
the delivery room is a different issue. FWIW, my SPD was so severe that
there is still evidence of it on stationary x-ray (swelling of the bone),
let alone x-ray taken in two different positions and comparing.

Ultimately, it's something you have to educate yourself about and manage
your own delivery accordingly, be prepared to suggest alternative positions
for VEs, that kind of thing.

Cheers

Anne

SPD also affects all joints of the pelvis.

no, sufferers of SPD are more likely to suffer pain/instability in other
pelvic joints, i.e. the SI joints, but they are two different things, SPD by
it's very name is just describing pain in the symphysis pubis, caused by
it's dysfunction, i.e. moving when it shouldn't be. Some people suffer
instabilty in the SI joints alone, some people suffer instability of the
hips, SPD is just the name for suffering that, along with pain in the
symphysis pubis, the joint at the front. There doesn't seem to be much of a
general consensus of a name for anything else, PPPP is one, peripartum
pelvic pain, as is PGP, pelvic girdle pain.

Cheers

Anne

as it's a pregnancy related problem you really should be able to get
continuing physio beyond pregnancy, so if you are seeing a physio now, they
should make a plan for you to book an appointment 6 weeks after delivery,
rather than you have to wait, see if you have more problems, go to the GP
and get referred back to physio, you need to stay with a women's health
physio than any other type.

also, NSAIDS are not that good for pregnancy, I don't have details to hand,
but pregnancy is one time when opiates may be a better option, though I
don't know if they work any better for SPD, but I'm not sure that NSAIDs
really work either, to minimise any swelling, there will be some, though it
is unlikely to be visible/feelable, try icing the area for 10 minutes before
bed everyday.

How did you find out the gap between the bones? I was told the only way was
by x-ray, so I'm curious as to how you know that whilst you are pregnant.
FWIW, there is no link at all with the horizontal gap, or the vertical
movement and the recovery rates post birth, which means some women have very
very severe problems during pregnancy and bounce back immediately at the
birth, but x-rays still show problems, and others don't bounce back and
their x-rays are not as bad, it's wierd, but basically no one has found a
way of predicting much!

there is a yahoo group for spd sufferes, spd_forum

cheers

Anne

Anne Rogers wrote:
as it's a pregnancy related problem you really should be able to get
continuing physio beyond pregnancy, so if you are seeing a physio now, they
should make a plan for you to book an appointment 6 weeks after delivery,
rather than you have to wait, see if you have more problems, go to the GP
and get referred back to physio, you need to stay with a women's health
physio than any other type.

also, NSAIDS are not that good for pregnancy, I don't have details to hand,
but pregnancy is one time when opiates may be a better option, though I
don't know if they work any better for SPD, but I'm not sure that NSAIDs
really work either, to minimise any swelling, there will be some, though it
is unlikely to be visible/feelable, try icing the area for 10 minutes before
bed everyday.

How did you find out the gap between the bones? I was told the only way was
by x-ray, so I'm curious as to how you know that whilst you are pregnant.
FWIW, there is no link at all with the horizontal gap, or the vertical
movement and the recovery rates post birth, which means some women have very
very severe problems during pregnancy and bounce back immediately at the
birth, but x-rays still show problems, and others don't bounce back and
their x-rays are not as bad, it's wierd, but basically no one has found a
way of predicting much!

there is a yahoo group for spd sufferes, spd_forum

cheers

Anne




Nope. Physio gave me something called an SOS certificate about a month
ago and told me to call the number post delivery. Then, a week ago, I
received a letter recinding the SOS and telling me to refer to my GP
post delivery. When I called to query this, I was told that they were
'cost cutting' and that I should contact my GP and get referred again to
Physio once the baby is born! Urgh. No-one seems to be taking ownership
and I feel like a pinball bouncing from one department to another and
getting told conflicting things. I am also seeing a consultant regarding
the damage caused by the last delivery and whether I need a C-Section to
avoid further and more permanent/widespread injury. I have been referred
to the Physio twice so far and I have not seen the same midwife in
months. No-one seems to know how to deal with all the related situations
together.

NSAIDS versus Opiates...The doctors and my sister (whom I trust more
than a doctor) who is a clinical pharmacologist both tell me the same
thing. Opiates pass through the placenta to the baby and can lead to
chemical dependancy. They tell me that NSAIDS taken with thought and in
moderation are a better alternative right now and that basically, the
best of the lot is to endure the pain for the remaining month(s) and
then re-assess the situation. I have no idea, direct evidence that this
is true but I do understand about women who take drugs and then the baby
is born addicted to that drug, especially opiates.

With regard to the gap in the SI, I didnt include my entire medical
history in my last post but after the birth of my last child, I did
briefly see a Physio who referred me to another doctor who specialised
in this. He did some manipulations which made me sick and then said that
he thought that the bone might be damaged. i was sent for an x-ray which
showed the gap. I was then referred to another consultant who was going
to do some sort of operation (what, i didnt quite understand). I was
sent away to wait for the appointment which to date has not
materialised. I then fell pregnant and that was that. I was actually
feeling much better before I became pregnant this time and I had hoped
that it was going away on its own. Apparently not.

The upshot of all of this is that the medical profession has told me
next to jack s**t about it. All I know, I have gleaned from the
internet. I know I am in pain 24/7. I know I dont like it and I wish it
would just go away. I used to be fit and healthy - I was a cross country
runner, swimmer and walker. I have no idea what is going to happen after
this pregnancy or whether any thing will happen at all. I've lost faith
in our local health trust but all I can do is keep on going. A home
still has to be run, a two year old still needs her mummy and somehow I
still need to earn a living. Me, frustrated? Nah.

Wookie

I've got loads to say, but we're moving this weekend!

Sounds like we've been though similar things re SPD, I'm very happy to email
you offlist, but I'll reply sometime next week to lots of things in your
post!

Anne