Bed Rest, Solar Jars, Surgeries, and windows

My brain works in circles, and while I focus a lot on core fitness, I’m also a wife and mother who lives in a fixer upper farm house. This blog is a mish-mash of intersecting things I experienced one week as a farm girl and fitness professional.

Our private members-only forum is always hopping and full of feedback, but my favorite from this week was when Christine G. wrote, “I am so excited because I was just ‘blessed and released’ from physiotherapy for my prolapse!! Yay! She thinks I have done beautifully and am ready for pelvic floor olympics. I couldn’t have done it without the support from fit2b. I now understand how important a strong core is and I feel that I can really maintain the work I have done in physio. Thank-you from the bottom of my pelvic floor, Beth! Thank you, also, ladies for your support.”

This somehow created a cascade of questions about surgical options for diastasis recti and pelvic floor troubles, which I realized I haven’t really written about. So when one member wrote, “I am in for prolapse surgery in a month, hoping this will help with the recovery, very glad it it is helping you, give me hope … not sure if physio would help with mine, no muscles where it has given way but I will certainly look into it. I spent some time reading pages, seems that 3 types can be helped but alas I have the 2 that can’t. I learnt lots in the process  I don’t have one of the I am going to lose an organ ones.” 

Well, after reading that and thinking back on so many articles I’ve read about how alignment and exercise play a HUGE role in prolapse, I whipped out a quick note to Julie Wiebe, a top physical therapist in this field. She’s in L.A. if anyone needs her, and this is what I commented back:

“I’ve been in touch with a top physical therapist this morning because from what I’ve read, it’s rare to have a prolapse that can’t be treated conservatively without surgery, but it sounds like you’ve already tried physical therapy? Julie Wiebe, PT is incredible, and I know you already have the surgery scheduled, but you never know… Here are just a couple more things to read from her (also for anyone who is reading and curious) Julie wrote to me and said, ‘Here is some conventional wisdom to the idea that once the organs have actually come out of the body that conservative management is no longer effective. But I treated one woman who did have some collapse outside the body, and she avoided surgery. I dunno, I always, always think that there wisdom in giving conservative management a shot before you choose surgery. The video on my home page also is about prolapse.’ No judgement here; I just want my members to be as fully informed as possible.”

Okay, before I talk about the other surgery thread we had in our member forum, I have to share what I found on my pinterest sweeps: I learned how to make a solar light out of a mason jar (basically you buy the lid that has the solar cell on it and screw it to a cute jar, but – hey – it’s a great tutorial, and I didn’t know such a thing existed) which is an idea I plan to use because of the upcycling aspect. I also read THIS ARTICLE that was pinned by my friend across the drink, Lorraine Scapens of Pregnancy Exercise, about how bed rest might NOT be the bee’s knees for pregnant mums! I’ve always wondered if putting a woman flat on her back (lowering bone density, weakening pelvic floor and core, raising cholesterol, causing weight gain) carried more risks than benefits, and it’s good to know it’s being researched! Especially because someone in our online forum asked about doing our exercises at 33 weeks with preterm labor.

Okay so then another member piped up and said, “I started with a 3 finger wide distastes. I worked out with a different program, and went from a 3 to a 2.5 in over a month. I got bored of it and just stopped doing it. I started doing your tummy safe workouts a week ago. I continued your exercises in the car, grocery store, watching tv, wherever I was… They were so easy to transfer into, my daily routine of life. I decided to check my distastes this morning, not expecting to notice a change.. I am currently at a 1! A, 1!!” Awesome, right? But then later, she wrote, “My husband is a skeptic so, we checked my belly together last night. All the way up my belly is a 1, except when it comes to my belly button area. For some reason, I have never checked that. Although, he can tell a difference everywhere else, he is still asking me to get the opinion of a surgeon. I feel like their are 2 different worlds when it comes to your body. The natural/homeopathic, and the dr/hospital. They each believe very differently. My husband is somewhere in between there. I couldn’t find anything on the site about why surgery isn’t the way to go. And he would also like to see more before and after pics. Was I looking in the wrong place? Can you direct me where to look? He isn’t interested in testimonials. He is just looking out for me, and needs more facts.. Beth Learn anything you can give me would be great.”

She’s closed her gap without surgery, but her husband is a skeptic and still wants her to talk to a surgeon??? 

I told her: Actually, I think you should go talk to a surgeon. And take your husband with you. No surgeon worth his salt will operate on you if your diastasis is closed. I guess I’ve never written about why one can/should avoid surgery because I figure it’s a no brainer: cost, recovery time, cost, the lady of the house going under the knife, cost, the fact that most other muscle issues are fixed with therapeutic exercises and binding/wrapping so why not this one, cost… LOL!!! Now, there is a time and place for surgery with VERY wide diastasis BUT the exercises are still crucial to keep pressure off those stitches, and those same exercises can help close the gap prior to surgery. There is a member who sent me her pictures of her surgery. I’ll ask if I can post them… Meanwhile, read these two pro-surgery sites

>>http://hernia.net.au/divarication/

>>http://www.realself.com/question/tummy-tuck-diastasis-abdominal-muscles-post-pregnancy-belly

Those make me mad by the way, because they don’t address what caused the bulge in the first place, they just do the surgery and turn the ladies loose! Gah!

So please know two things: the two most popular ways to surgically fix DR is via stitching the two sides of the abs together (nothing but stitches holding your abs in) or stapling/stitching a mesh to your abs to hold it all in. Meshes are on their way to recalls because they CURL after 10-15 years! Blech! Read this from a Tupler instructor who went incognito to two surgeons… hehe!”

How is diastasis and prolapse typically treated?

Surgery! I’ve talked personally with women who have had their abs sewn back together, or stapled down the middle, or have had meshes put in {vaginally or abdominally to try to hold things in}… yet they still join my site. Why? Because their core is still weak. Their bellies are still pooching out. And sometimes they’ve got weird interior pain, and I must tell them to “Get thee to a doctor!” Because there’s a recall on meshes, and stitches don’t always hold.

Men and women go to a DOCTOR to find out why their abs are getting bigger when doing “ab work” instead of smaller (Please read my letter to Doctors who don’t understand diastasis). Sadly, unless you know to ASK for physical therapy – you will likely be referred to a surgeon and then be given carte blanche permission to do “whatever” because your abs have “been fixed.” The surgeon will blithely tell you that “a belly is normal after having a baby/hernia/obesity/IBS/etc, and elective surgery is the only option.” How much will that cost, doc? “Oh, well, since insurance sees [the fixing of a distended stomach] as a vanity issue and, let’s face it, it kind of is (dry laughter) -0 you’re looking at $7,000 to $10,000 USD.”

That was a direct quote, people, from a letter I got from a very distraught woman who KNEW her core was broken, couldn’t afford “vain” surgery, found out about me, checked herself for diastasis, realized the doc never checked her for it {plenty of other women say they were checked but still offered the surgery instead of physical therapy or exercises} and found hope that she could heal it herself. And she did, starting on Fit2B with our routines and then moving onto Kelly Dean’s online physical therapy. Then she was ready to go back to the gym with a better understanding of what her core needed to get even stronger!

Side Note of Sarcasm: I just love reading research articles…especially ones from the eighties (NOT) where they talk about dissecting each abdominal muscle and separating it to determine it’s strength. Too bad we know now that the abs work in unison AND separately AND they pull on each other via the linea alba. We have come so far (again, not) when many ab studies are still done with electromagnetic sensors that only pick up what’s going on in one or two layers of abs… Le Sigh.

You see, something I had almost forgotten during the ego of the years after I completed college – and something I believe most fitness trainers have forgotten – is this troublesome physiological fact: your abs are NOT a continuous chunk of muscle(s) like the biceps or the quadriceps or your gluteus maximus. They are layered and woven together by fascia right in the middle, and they each play a role, and the TA’s job is to draw its buddies – the rectus abs and obliques – inward and not let them bulge way out and to hold them steady while they’re busy doing their jobs. TA deflation and weakness often corresponds with wider DRs.

It’s not funny that there’s so little info out there for women who want to put their bodies back together. It’s not funny that surgery is almost always the first proposal to a person with this particular muscle issue. If it was any other muscle, insurance would insist on physical therapy before surgery.

But here’s the catch, while prolapse surgery is usually covered and no physical therapy recommend (yet vaginal meshes are being recalled in Canada) surgery for diastasis is often not covered unless it’s misdiagnosed as hernia or coincides with hernia. Why? Because it’s considered a vanity issue. The pooch that relates to bigger health issues like bowel obstructions, incontinence, hernia, lower back pain (of which 50% of americans claim disability coverage for their lower backs – wonder if it’s actually diastasis?) is considered vanity?????? 

Please leave a comment

Share your thoughts and experiences with surgery, diastasis, weird doctor stories, or HEY even your random pinterest finds that helped your remember you are more than your abs.