What kinds of help can I give to Mom with a prolapsed vaginal wall?
She's been to several doctors and finally a specialist said the vaginal wall was falling out of her vagina. Mom will be 94. She has been told to do Kegel exercises. What else can be done? She said it feels like a baby head is going to come out.
My Mom had to go through many visits to be fitted with the right size pessary. Now she has to use some sky-high darn cream with it: premarin. But at least the only thing that is annoying now is the expensive cream. At 95 everything else is still working.
MIL had surgery in December there is a name for it, but basically she had her vaginal opening stitched closed so her lady parts stay inside. This surgery was a must have for her & has been very successful. She continued to have issues with incontinence, however a recent rx for that has helped greatly. She is back to being able to sit down and even get up!
teaka, the donut pillow was excellent they used to be use for pressure sores but have gone out of favor because it is thought the pressure gets transferred to the rim. I don't agree and use one in the car on long trips and if i find my tail bone getting sore. The D 's solutions sound good too. you could also put some of the coconut oil on a piece of cotton cloth next to her body underneath everything else. Sitting in a recliner might also be more comfortable and take some of the pressure off if she reclines a little. When she gets up have her helped and tell them to turn her on one hip and slide her legs to that side before standing. When helping do not pull on arms but put round her body to assist. there is a technique to assist someone get up from an upright chair as long as they are not too heavy. the helper stand toe to toe with the patient. Helper bends forward and pt places hands round helpers neck and grasps her own hands. helper places own arms round pts body under arms and they both stand up. takes some practice so try it on someone small other than the patient. Any transfers are safest with two people but I know most caregivers don't have that luxury. Pain pills may not be really effective in this case and further confuse your loved one but a small dose of an anti anxiety would be helpful. Be very careful with the dose so she does not fall and create more problems for herself. At least your loved one was actually eating her dinner even if she was standing up!
MIL saw the urogynocologist last monday. They will be doing an ultrasound and bladder test in three weeks. Her uterus was too sore for them to do a pelvic exam to the necessary extent. Thursday she called the nurses so many times that they decided it would be necessary to move her temporarily to a wing with more skilled nursing care available as she was calling for help all the time. She is uncomfortable, but she is also becoming increasingly befuddled by everything (pulling up her pants, etc.). Called the Dr. and let them know what was going on and they will see her again this next week. In the meantime to help her with the discomfort they said to apply a food based oil to the exposed area (we purchased coconut oil), and to use saran wrap (yes, saran wrap) to help retain moisture. A soft sanitary pad could always be used like a pillow between all that and her underwear (they were irritating her). This advice is coming from the UW urogynocologist clinic one of the top in the nation - just in case anyone thinks this sounds like odd advice. Also, we checked in on her this evening and she was downstairs in the dining room eating her dinner standing up. Standing (gravity) does not help the prolapse, but clearly she was too uncomfortable to sit. We left and returned with one of those small inflatable donut cushions to sit on (probably used for people w/ hemroids?). We are hoping it will help some. We are also going to ask the dr if they will prescribe her a pain tablet - partly to help with the discomfort and partly to relax her.
When my mom started having urinary incontinence, she would go on & on & on about refusing to wear "the post". OK mom, nobody is going to make you wear the mail. ???? **Now** I know she meant a pessary. She absolutely would not talk to a doctor -male or female- about this problem. Wild horses could not get it out of her, which is sad. If we don't talk about it, it's not happening, right.... Sheesh.
I think this dark and mysterious subject is less of a problem now that childbirth is managed better and vaginal repairs are done more carefully. By the time a prolapse happens Kegals will probably be of little help. The time to do them is after giving birth or when minor incontinence occurs. Judda your mother is certainly very old for surgery and of course the risks are increased at that age. If it is really causing her a great deal of distress and she is not demented and would like the problem fixed the surgery could be done with spinal anesthesia and a strong sedative so she is not aware. 2-3 days in the hospital and a catheter for a couple of days. She will need pain medication for a few days so do not let her become constipated. I can't remember if you are caring for her at home or she is in a NH? Teaka your MIL has the added complication of a heart condition that may make surgery more dangerous but she also could be a candidate for spinal anesthesia. If they advise stitching the vagina closed that would be simple to do as an outpatient procedure with local anesthetic and a sedative if she is anxious. Again it all depends on how stressful she finds the problem and how bad her heart is. If she potentially has a few good years ahead she may be willing to take the risk. Hysterectomies can now be done with the DeVinci procedure which is robotic but this does need GA as the patient is tipped head down. otherwise mostly they can be done vaginally, no longer the major abdominal surgery that used to be the case. My own mother had hers done about 1950 and was in hospital 10 days. Did not know what it was about till I was an adult and in nursing school. I did have to try and replace a hospice patient's bowel one morning. For the record I was not successful.
Watching this thread. This is like the last female taboo that "nice" people don't talk about out loud. My grandmother had a prolapsed something, but my mom and her sisters would NOT explain a thing to me. It sounds horrifying but so many women have to deal with it. Kegel Kegel Kegel Kegel Kegel.
We are dealing with this very thing with my MIL - 85 yrs. A pessary will no longer work for her. We have an appointment with a urogynocologist (urology gynecology) next week to learn of our options. Given her age and heart condition we do not think a hysterectomy is an option (even if it was I would be uncomfortable with the idea of anesthesia). I understand one option may be to stitch the vaginal opening almost all the way closed so that it holds things in for her, but still allows for body fluid discharge. Until the appointment we have asked for her water pill to be decreased, scaled back her fluid intake and advised her to try and stay off her feet (this is a real challenge as she does not read or watch tv). She can also wash her hands well and tuck herself back in place. We purchased her the type of depends that will velcro so that she does not need to remove her pants and shoes each time she needs a change. Hoping that the new walker with a seat will get her to sit not stand as much, but getting from a standing to sitting position is very uncomfortable for her to do. I will post what I learn from the urogynocologist next week.
At her age, I would not have surgery. I am 67 yr old and have a prolapsed uterus. My Doctor recommends surgery and I look forward to getting this taken care of. Hopefully, I will get some relief. Why does no one tell you this could happen?
Well for one, tell mom NOT to push a bowel movement. That straining, especially with a hard stool, is pushing on the vagina too. My grandmother (who would now be 125) used alum somehow but I have no idea what her recipe was. It was either a sitz bath or a douche.
Mom was fitted with at least three different pessaries and all of them failed. They didn't fail to bill her for all this though. Mom decided it was useless and I can't get her to try another doctor or keep trying until one works. Is it harder to fit a vaginal wall than a prolapsed uterus or bladder?
Would she be able to use a pessary? My sis put up with a prolapse for years because her doc and nurses were reluctant to go that route. Recently she finally got to a doctor who fitted her for one and had instant relief of most of her symptoms.
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there is a technique to assist someone get up from an upright chair as long as they are not too heavy. the helper stand toe to toe with the patient. Helper bends forward and pt places hands round helpers neck and grasps her own hands. helper places own arms round pts body under arms and they both stand up. takes some practice so try it on someone small other than the patient. Any transfers are safest with two people but I know most caregivers don't have that luxury.
Pain pills may not be really effective in this case and further confuse your loved one but a small dose of an anti anxiety would be helpful. Be very careful with the dose so she does not fall and create more problems for herself.
At least your loved one was actually eating her dinner even if she was standing up!
When my mom started having urinary incontinence, she would go on & on & on about refusing to wear "the post". OK mom, nobody is going to make you wear the mail. ???? **Now** I know she meant a pessary. She absolutely would not talk to a doctor -male or female- about this problem. Wild horses could not get it out of her, which is sad. If we don't talk about it, it's not happening, right....
Sheesh.
By the time a prolapse happens Kegals will probably be of little help. The time to do them is after giving birth or when minor incontinence occurs.
Judda your mother is certainly very old for surgery and of course the risks are increased at that age. If it is really causing her a great deal of distress and she is not demented and would like the problem fixed the surgery could be done with spinal anesthesia and a strong sedative so she is not aware. 2-3 days in the hospital and a catheter for a couple of days. She will need pain medication for a few days so do not let her become constipated. I can't remember if you are caring for her at home or she is in a NH?
Teaka your MIL has the added complication of a heart condition that may make surgery more dangerous but she also could be a candidate for spinal anesthesia.
If they advise stitching the vagina closed that would be simple to do as an outpatient procedure with local anesthetic and a sedative if she is anxious. Again it all depends on how stressful she finds the problem and how bad her heart is. If she potentially has a few good years ahead she may be willing to take the risk.
Hysterectomies can now be done with the DeVinci procedure which is robotic but this does need GA as the patient is tipped head down. otherwise mostly they can be done vaginally, no longer the major abdominal surgery that used to be the case. My own mother had hers done about 1950 and was in hospital 10 days. Did not know what it was about till I was an adult and in nursing school.
I did have to try and replace a hospice patient's bowel one morning. For the record I was not successful.