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#1
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update on my recovery (bit of bad news)
the readership has changed somewhat, so here's a brief "what happened", I
had severe SPD in my 2nd pregnancy (milder in my first), and at the end, I developed all over body pain that basically left me unable to move, I spent the last week in hospital being pumped full of pain meds, my daughter was then delivered in the OP (back to back) position in a very painful (on the joints) 2nd stage that took 8-10 times as long as my previous 2nd stage. It was evident soon after the birth that there was more damage than just SPD that didn't heal spontaneously as there was swelling and pain in places there hadn't been before. Fast forward 19mths, I'm a heck of a lot better than I was, but still with some pretty significant problems. I've been working with a physical therapist who is also a pilates instructor, which means she is hands on, feeling how my muscles are working in the various exercises, for much more time than in a regular physical therapy appointment, so that has allowed her to really get to know how things are working and unfortunately what she thinks, is that my muscles are doing a good job, they are responding at the correct time and doing all the work they can to stabilise things, without going in to spasm and permentantly switched on and causing pain in that way, which means we have to look at the next level down, the ligaments that hold the symphysis pubis together are just not doing their job and physical therapy can't fix that. Reflecting on how they got in that state, my understanding is pregnancy makes the ligaments looser, it doesn't stretch them beyond the point they can spring back to, it must be birth that did that (I'd always blamed the birth, but I hadn't had such concrete evidence). So where next, the surgery for SPD is not ligament focused, like say a knee reconstruction, it's a bone operation, they fuse the two sides of the pelvis, it's major surgery, long recovery and only about 50% sucess rate, I don't feel that my current condition is bad enough to take that kind of risk. The other option is a ligament treatment called prolotherapy, it's not covered on insurance as it's way out there as an alternative therapy, there is only one practioner in reachable distance and absolutely no information that I can find on it's success rates, I've never come across anyone in all my perusing of online boards and groups, someone who has even tried this, so whilst it seems it's an idea that I must visit, I'm not desparately keen either! I think I need to just pluck up the courage to go and have a consult, not accept any treatment first visit and try and get more information. My physical therapist has someone who went to this guy for a different problem, but I think vaguely related as I seem to recall it was SI trouble with good results and she is trying to put us in touch. I've also been musing over what effect this might have on pregnancy and birth, part of me is wondering if the damage is already done and whilst pregnancy would be hard, delivery wouldn't be an issue, but a bigger part of me is saying that this ligament has definitely recovered some since and then putting a baby through it might be ok if the baby is well positioned, but not so good if it isn't and that maybe even putting a baby through it in the right position would be a bad idea, a bit like stretching a spring, if it's in good condition it goes back, if it isn't, it doesn't and the amount it has to stretch may well not make much difference, it may just be best it doesn't stretch at all. I feel more relaxed about the idea of a c-section than I did, so that's not really an issue, I'm not even desparately concerned about pregnancy, whilst SPD makes pregnancy difficult and even hellish for the last few weeks, it is still only 9mths (and there are other discomforts that are equally troubling, I get stupid food and smell aversions and last time I was sick right through, though not extremely so and not accompanied by nausea) and with the right support in place, I can hack that and it would be likely that one or both kids would be in school and we could get a nanny or other help if needed, what I'm rather more concerned about is the recovery afterwards, there is no way of knowing whether it will be worse, the same, or better, the hope would be that avoiding vaginal delivery would avoid further damage, but being heavily pregnant does at least some percentage of the damage too and c-section means in the short term the abdominal muscles are worse. I needed to put this in words today, so I can put it to one side and get on with life, the earliest I can even imagine getting pregnant is summer 2009, regardless of all these troubles! Hopefully some people are interested to hear how things have gone ;-)! Anne |
#2
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update on my recovery (bit of bad news)
Anne Rogers wrote:
The other option is a ligament treatment called prolotherapy, it's not covered on insurance as it's way out there as an alternative therapy Actually, it isn't at all "out there", except perhaps for using dextrose (per www.prolotherapy.com) instead of the old standby agents heat or acid or something (anything) else. It is basically what horsemen know by the name "pin firing" and the idea is to fight inflamation with inflamation. Does it work? My personal experience has been that counter inflamation does not work. Good luck with your research. |
#3
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update on my recovery (bit of bad news)
The other option is a ligament treatment called prolotherapy, it's not
covered on insurance as it's way out there as an alternative therapy Actually, it isn't at all "out there", except perhaps for using dextrose (per www.prolotherapy.com) instead of the old standby agents heat or acid or something (anything) else. It is basically what horsemen know by the name "pin firing" and the idea is to fight inflamation with inflamation. Does it work? My personal experience has been that counter inflamation does not work. Good luck with your research. it depends what you mean by "out there", in terms of the logic behind it that makes it work, it's exceedingly logical, though my understanding was that whilst it causes localised inflamation in the area being treated which then stimulates tissue repair, the area doesn't have to be inflamed to start off with, so it's not so much treating inflamation as treating damaged tissues, so it's not "out there" in that sense. The sense in which it is "out there" is that most states seem to have under 5 practioners, so it's a rarely used therapy, hence very little research basis purely due to lack of numbers, it's rarely covered by insurance (though that doesn't necessarily imply out there, acupuncture has great research support yet is rarely covered). It's even more out there for my case because via prolotherapy sites and SPD sites, I can't find any related case histories, so chances that the doctor I go to will have seen anything like my case before is almost zilch, which all add up to me as it being "out there". The good news is that it doesn't seem to hurt during treatment, other than the discomfort of the actual injections and there doesn't seem to be anything other than minor risks, which makes it fall into the "worth a try" category rather than the "approach with caution" category. I'm not sure what you mean by "my personal experience...", have you had prolotherapy? or some kind of related therapy? Cheers Anne |
#4
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update on my recovery (bit of bad news)
"Anne Rogers" wrote:
[...] whilst it causes localised inflamation in the area being treated which then stimulates tissue repair Repair? Most proponents claim it strengthens. That is not necessarily repair. There is some evidence that the treatment actually damages the vascular and nerve supply in the vicinity of the injection sites. No living nerves confers less pain. But in no sense is this tissue repair. There is a Cochrane review. |
#5
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update on my recovery (bit of bad news)
On Jan 31, 10:27 pm, "Anne Rogers" wrote:
the readership has changed somewhat, so here's a brief "what happened", I had severe SPD in my 2nd pregnancy (milder in my first), and at the end, I developed all over body pain that basically left me unable to move, I spent the last week in hospital being pumped full of pain meds, my daughter was then delivered in the OP (back to back) position in a very painful (on the joints) 2nd stage that took 8-10 times as long as my previous 2nd stage. It was evident soon after the birth that there was more damage than just SPD that didn't heal spontaneously as there was swelling and pain in places there hadn't been before. Fast forward 19mths, I'm a heck of a lot better than I was, but still with some pretty significant problems. I've been working with a physical therapist who is also a pilates instructor, which means she is hands on, feeling how my muscles are working in the various exercises, for much more time than in a regular physical therapy appointment, so that has allowed her to really get to know how things are working and unfortunately what she thinks, is that my muscles are doing a good job, they are responding at the correct time and doing all the work they can to stabilise things, without going in to spasm and permentantly switched on and causing pain in that way, which means we have to look at the next level down, the ligaments that hold the symphysis pubis together are just not doing their job and physical therapy can't fix that. Reflecting on how they got in that state, my understanding is pregnancy makes the ligaments looser, it doesn't stretch them beyond the point they can spring back to, it must be birth that did that (I'd always blamed the birth, but I hadn't had such concrete evidence). So where next, the surgery for SPD is not ligament focused, like say a knee reconstruction, it's a bone operation, they fuse the two sides of the pelvis, it's major surgery, long recovery and only about 50% sucess rate, I don't feel that my current condition is bad enough to take that kind of risk. The other option is a ligament treatment called prolotherapy, it's not covered on insurance as it's way out there as an alternative therapy, there is only one practioner in reachable distance and absolutely no information that I can find on it's success rates, I've never come across anyone in all my perusing of online boards and groups, someone who has even tried this, so whilst it seems it's an idea that I must visit, I'm not desparately keen either! I think I need to just pluck up the courage to go and have a consult, not accept any treatment first visit and try and get more information. My physical therapist has someone who went to this guy for a different problem, but I think vaguely related as I seem to recall it was SI trouble with good results and she is trying to put us in touch. I've also been musing over what effect this might have on pregnancy and birth, part of me is wondering if the damage is already done and whilst pregnancy would be hard, delivery wouldn't be an issue, but a bigger part of me is saying that this ligament has definitely recovered some since and then putting a baby through it might be ok if the baby is well positioned, but not so good if it isn't and that maybe even putting a baby through it in the right position would be a bad idea, a bit like stretching a spring, if it's in good condition it goes back, if it isn't, it doesn't and the amount it has to stretch may well not make much difference, it may just be best it doesn't stretch at all. I feel more relaxed about the idea of a c-section than I did, so that's not really an issue, I'm not even desparately concerned about pregnancy, whilst SPD makes pregnancy difficult and even hellish for the last few weeks, it is still only 9mths (and there are other discomforts that are equally troubling, I get stupid food and smell aversions and last time I was sick right through, though not extremely so and not accompanied by nausea) and with the right support in place, I can hack that and it would be likely that one or both kids would be in school and we could get a nanny or other help if needed, what I'm rather more concerned about is the recovery afterwards, there is no way of knowing whether it will be worse, the same, or better, the hope would be that avoiding vaginal delivery would avoid further damage, but being heavily pregnant does at least some percentage of the damage too and c-section means in the short term the abdominal muscles are worse. I needed to put this in words today, so I can put it to one side and get on with life, the earliest I can even imagine getting pregnant is summer 2009, regardless of all these troubles! Hopefully some people are interested to hear how things have gone ;-)! Anne Anne, Just wanted to say I'm sorry for the difficulties. I don't quite understand it all, but I'm sorry you have to deal with it. I hope something can be sorted out before you decide to TTC again. |
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