A Resource to Help You Get Informed Post-Surgery and Have the Best Chance of Recovery

Prolapse Repair Surgery is a big step to take. It is major surgery, usually with a fairly long recovery period. Added to that is the relatively high rate of failure, which makes it all the more important for you and your surgeon to work as a team for the greatest possible chance of success.

 

However, it can be difficult to be a team if you do not have a clear method of communication. Often, information about how a procedure went, and what you need to do to look after yourself post-surgery, is given to you in the recovery room or in the days following the surgery while you may still be disoriented or overwhelmed.

 

The National Patient Safety Foundation in America has recognised this, and has created a tool to help you and your surgeon clearly record your discharge information. It is a PDF, and can be downloaded here: Post-Discharge Tool.

 

This excellent resource includes spaces for you and your surgeon to record:

• Follow up appointments, including a plan for what you need to bring and ask at each appointment
• A clear diagnosis
• A checklist of important steps during your recovery
• A medication list, including detailed information about doses, and the reason you need to take each medication

If your medical practice includes post-surgical care, distributing this resource to your patients may improve your surgical outcomes, and field fewer phone calls asking for clarification of your instructions.

 

Everyone involved in managing prolapse, both patients and health professionals, benefits from improved communication.  

 

 

"Healthy Women's" Tips for Talking to Your Doctor

 

Healthy Women is a non-for-profit organisation that aims to provide accurate health information for all women.

They recognise that sometimes it can be difficult to talk to your doctor about women's health issues, such as prolapse. To help you approach your doctor, and get the most from your consultation, they have created the following webpage: Tips for Talking to Your Healthcare Provider.

The tips are very practical, and include:

• Specific questions to ask at each appointment
• A few sentences you can use if you feel uncomfortable asking your doctor to clarify what they have said
• Letting your doctor know if you have trouble reading, so they can give you information in another way
• When to change doctors

The second page of the article discusses some ways in which you can use email to stay in touch with health care providers, and save you unnecessary appointments.

 

Speaking up, even when you are in an intimidating situation, is a great way to improve your level of medical care.

 

 

Australian Women: You May be Eligible to Receive Some of Your Prolapse Treatment through Medicare

 

Medicare is the Australian system of free healthcare for all citizens. This system has many good features. However, it can still be difficult and expensive to manage a long-term health condition such as prolapse if you need the support of a health professional such as a Women's Health Physiotherapist.

 

There is a little known Medicare entitlement called the Chronic Disease Management Plan. Despite the name, it can be applied to any health condition, including prolapse, that has been going for more than six months.

 

Once a GP has written a Chronic Disease Management Plan and Team Care Arrangement that involves at least two other specialists (such as a Women's Health Physiotherapist, a Continence Nurse or a Urogynaecologist), you may then be eligible to claim a rebate for these services from Medicare. This plan also helps to coordinate your care between your specialists.

 

If you are an Australian citizen and do not have private health insurance, a Chronic Disease Management Plan may enable you to access all the services you need to manage your prolapse effectively.

 

For more information, go to the following website: Chronic Disease Management Plan.

What the National Guideline Clearninghouse Says About POP May Surprise You

Ever wondered just what your doctor or specialist was thinking when they recommended a particular treatment for Pelvic Organ Prolapse (POP)? The US National Guidelines on POP may help shed some light on their thought process.

 

The National Guideline Clearinghouse is part of the US Department of Health and Human Services. Their recommendations about Pelvic Organ Prolapse summarise all of the research on the topic until 2011 in a single page of dot points. You can read these guidelines here: Pelvic Organ Prolapse: Recommendations.

 

The most interesting part of these guidelines is the difference between the guidelines from good-quality research (Level A evidence) and the guidelines based on 'professional knowledge' from health care providers who treat POP (Level C evidence).

 

The agreement between healthcare providers is that women with POP who were asymptomatic (had no symptoms) or who had mild symptoms required no treatment. Many women with 'mild' POP, who perhaps experience discomfort or mild pain and incontinence, may be familiar with this view; having been told by health professionals that they do not require treatment.

 

However, there is no evidence from good-quality research that mild POP should go untreated. In fact, the National Guidelines state that a pessary would be appropriate for most women regardless of the degree of their prolapse.

 

We often assume that health professionals are acting based on the most up-to-date scientific evidence, but it is worth remembering that they are also using information that they received during their training, or impressions they have formed during their career.

 

If you have mild prolapse, have seen a health professional who believes you do not require treatment, and can not change health professionals, then it may be worth printing out this section of the guideline while trying to demonstrate to them that you need treatment.

 

Remember that at the Prolapse Information Network I recommend that you continue to seek medical help until you receive it. You are entitled to receive evidence-based, appropriate treatment for your prolapse.

Get Informed about Pelvic Organ Prolapse at "Healthy Women"

 

Healthy Women is a not-for-profit organisation that aims to empower women by giving them accurate information about their health conditions.

 

The section of their website about Pelvic Organ Prolapse (POP) is much more detailed than the average information sheet. You can find it here: Pelvic Organ Prolapse.

 

It has separate pages on the following topics:

• Diagnosis
• Treatment
• Prevention (particularly useful for pregnant women)
• Questions to ask your health professional
• Answers to common questions (including some questions I haven't really seen addressed on other websites, such as "My doctor says I have some bladder prolapse, but I don't have any symptoms. How is that possible?")
• Organisations that can offer help and support (mainly in the US)

This is a great place to start your in-depth reading about POP, once you have taken a look at a few information sheets.

Tips for Talking to Your Doctor About Prolapse

Speaking to a health professional about the symptoms of your prolapse can be difficult. We are taught not to discuss bodily functions, sex, or our genitals, and it can be hard to overcome this even with a doctor. It can be particularly difficult have that first conversation where you disclose your symptoms.

 

The American Association of Urogynaecologists has created a really useful document to guide you through that first conversation: Tips for Talking with Your Doctor.

 

It has two parts.

 

On the first page, there is a questionnaire for you to fill in and take to your doctor's appointment. It covers most of the questions your doctor is likely to ask if you tell them you are experiencing symptoms that could be caused by a prolapse.

 

On the second page, there is a list of questions that you might like to ask your doctor in an initial meeting, to help you get a clear diagnosis, and a pathway towards further medical care.

 

It is really important to go into medical appointments as prepared as you can be, to make sure that your concerns are heard. If you are getting a friend or family member to act as an advocate, they might be able to help you fill in the questionnaire, or ask questions during the appointment.

 

Doctors, you may like to get your female patients to fill in the questionnaire on the first page in order to help you screen for women who are experiencing prolapse or other pelvic floor dysfunction. This is a great way to begin a conversation with your patients about a topic they might be desperate to discuss, but that they feel unable to talk about with you.

The Importance of Getting Your Prolapse Information from Professional, Scientific Sources

Make sure you are selective when getting medical information from online sources such as You Tube

 

The internet is a great tool for managing your prolapse. Considering that many doctors still do not have a good awareness of prolapse, it is a place where you can find out more about your condition. Even though most people feel uncomfortable discussing prolapse in person, online you can find lots of people willing to share their experiences with you.

 

However, there is a downside to using the internet as your primary source of information, and that is making sure that the information is accurate, based on science, and that the person giving you the information has no ulterior motive.

 

A good example of this problem is You Tube videos about mesh surgery. A recent report presented at the American Urological Association 2014 Annual Scientific Meeting found that two thirds of all videos about mesh surgery for prolapse were posted by legal firms. Lawyers are not generally recognised as experts in women's health. It is more likely that they posted these videos, usually very critical of mesh surgery, to try and find women who had experienced complications from mesh surgery and would like to sue. You can read an article on this case here: Patient Perceptions of Vaginal Mesh From YouTube and TV.

 

When looking for information on managing your prolapse, think carefully about what the person who produced the information may be hoping to achieve.

 

A good place to start is here, at the Prolapse Information Project. I have no financial share in any prolapse-related products, and I strive to bring you only scientifically-backed information from reputable sources.

A Not-For-Profit Organisation Providing Cheap Continence Aids in Australia

 

Independence Australia is a not-for-profit organisation that aims to help people with disabilities lead full lives.

 

They fund their work partially through their store, which sells a variety of disability aids and continence products. You can visit their store online here: Independence Australia.

 

Because Independence Australia want more people to be able to access the items that they sell, they often offer good discounts. They also offer online shopping, and discreet delivery. Any profits go to supporting their other work, such as providing attendant care and counselling to people with disabilities.

 

This information is provided merely to make you aware of the services available. The Prolapse Information Project has no association with Independence Australia, and does not endorse any one retailer or product.

Wound Care - How to Look After Yourself Post-Operation or After Childbirth

 

There is a lot of conflicting information on the internet about how to care for wounds. Much of it is unfortunately not based on clear evidence.

Your first source of information should of course be the health professional who performed your surgery or delivered your baby. However, it can be difficult to know where to turn if the information you have received is insufficient, contradictory, or if you received no information at all.

The following page from Mater Hospital in Queensland provides up-to-date information on how to care for a third or fourth degree tear following childbirth: Recovering from 3rd or 4th degree perineal tears.

 

Though this page naturally includes specific information on third a fourth degree tears, it also has good general guidelines on caring for genital wounds. It also warns you against some of the incorrect advice circulating on forums (such as drying yourself with a hairdryer, which can put you at risk of burns if you have reduced sensation in the area). Remember, online forums are best used as a source of support, or as the start of your research into your treatment.

 

The most important thing to remember is that your wound requires regular cleaning and monitoring. Though you may not want to look at or touch the area, particularly if you have just had a traumatic birth, it is vital that it receives proper attention. If you can not bring yourself to care for your wound, ask a trusted family member or friend to help you. If you do not feel comfortable doing this, then you need to urgently seek help from your doctor or hospital. You are at risk of infection or other complications if you do not keep your wound clean. If you cannot get help anywhere else, go to your local hospital emergency department, and explain that you need mental health support in dealing with your wound.

 

As always, I encourage you to ask for the help you need, and to continue asking until someone helps you.  

At the Prolapse Information Project, I always recommend you seek professional medical advice, even if it means that you need to seek a second opinion in order to feel confident about what you have been told. The information in this article is provided only to help you become informed about your care.

Which Health Professional Should You be Seeing?

 

 

Being diagnosed with a prolapse can plunge you into a world filled with unfamiliar medical terminology.

 

One of the most confusing things can be navigating which type of professional you should seek help from. A continence nurse? A women's health physio? A urogynaecologist? What the heck even is a urogynaecologist?

 

The Continence Foundation of Australia has put together a really informative page that tells you what the qualifications of each of these professionals are, and in what situation they can help you. This is particularly important when finding a properly qualified physiotherapist, or when choosing which type of professional should perform your surgery (if you choose to have surgery).

 

This great resource is available here: Which Health Professional?
 

Remember, the Continence Foundation of Australia can also help you to find an appropriate practitioner close to where you live. Call their help line 1800 33 00 66 Monday to Friday 8AM to 8PM.