Pelvic Instability / Pelvic Girdle Pain – Anyone who’s been there or going through it

[mumintraining]

Hi, I am suffering from pelvic instability / pelvic girdle pain whatever you prefer to call it. It’s terribly painful and I have just come home from hospital as a result of it progressing beyond a point I could handle. I am seeing a physio and taking all the appropriate steps in terms of moving/lifting/support aids etc. I am now also on Endone (only 4 days worth unfortunately) and Panadine to try manage the pain. I also use hot/cold packs etc to help. My reason for mentioning this is I have just gone through the whole process of explaining and proving that I really am at the end of what can be done to help.

The reason for this post is to try find others who are either going through this or have experienced it who can pass on information that could be useful. My primary concern is that I am now unable to move easily (I can slowly do things and shuffle around) and I am the primary career of a beautiful but active 16mth old son. I still have 9 weeks to go and even though my GP, OBS, Psychologist and DH are all supportive I don’t know how to survive the remaining time and recovery period.

Has anyone come across support groups or resources that specifically deal with this type of problem that could help me on an emotional level?

Secondly are there resources out there or ways to find help with the problems of being temporarily stuck with reduced mobility and caring for a small child?

While I don’t want to use the term disabled as it is only temporary I do realise that at the moment my ability to perform everyday tasks and functions of both my own care and my families is significantly reduced. As I have never been in this situation before I don’t know what to do or where to look.

While my DH has taken the week off to care for DH and I he is not in a position to become a full time career for the next however many weeks without affecting his Study/Work and our sole income. My In-Laws are the only other family here but they both work and are already trying to help out in their limited free time.

Hope someone out there can shine a little light on things.

MIT

[alioops]

I Know EXACTLY what you are going through. I have a walking frame that I got when my symphisis pubis separated. Thankfully I dont need it any more. I got my frame at 27 weeks pg. I spent the last month of my pregnancy in a wheelchair and had to have one of our parents here full time to care for the older kids. It might be worth hiring a live in nanny if you can't rely on family because unfortunately it wont get any easier. I was on Panadine Forte for 3 months.

I had DD3 vaginally. Avoid drugs so that you are aware of any pelvic pain. Gas and air is fine but if you do need an epi then you need to talk to your care provider about a CS in that instance. If anything the pelvic issues made birth easier, DD came out facing my left leg. I will see if I can find my birth story for you.

All you can do at this stage is keep using your brace 24/7, Ice, pain meds, and lay down as much as possible. If you have any more Qs I am happy to share more of my experiences with you.

ETA: Here is my birth story

[maranui]

Hi MuminTraining

You poor thing - I can understand why the pain is getting you down

I had very bad pubic symphisis pain at about the 30 week mark and wondered if I would ever be fully mobile again in pregnancy. While my pain doesnt sound as bad as yours, it certainly stopped me walking distances of more than 50 metres at a time. I could also forget about sleeping without my tummy well propped up and a huge pillow between my legs too.

I got a pre-natal cradle online and also used a belly bra (when it wasnt hot!), but mainly spent lots of time sitting in a lazy-boy. I kept doing my kegel exercises with a vengence through this period despite it being the last thing I felt like doing. I also visited a very good osteopath who would spend 40 minutes doing gentle work on my pelvis.

Then, bizzarely, it seemed to improve at about 34/35 weeks. Now I realise it was probably just pain assosiated with a big growth spurt and a big stretching of my pelvis.

I am now comparatively mobile and can walk to the corner store.....well that is if I hadn't torn my calf muscle.

Keep your chin up. I know the pain feels like it wont end, but the one thing everyone said to me is that it would (and it did).

[mumintraining]

maranui - I'm glad to hear that it resolved itself for you as it really isn't easy. I will certainly do the pelvic floor exercises as its one of the few activities I can do - probably end up with better streangth down there than I did after DS as a result. Unfortunatly as this has been since week 12 and only increasing I don't think it will get better till baby is out, still if it does I would be over the moon.

alioops - Thank you for reaching out to me, one of the things I am worried about is that I might very well end up in a wheel chair as I can't push myself much further than I am already doing. I might very well need a walking frame just to be able to get up and down off seats, as it is I have a second chair with arms on it to help with lowering me onto the toilet. Pregnancy and bathroom trips is annoying enough without needing to psyc yourself up first.

One of the MW's mentioned that the OBS might want to reccomend a CS, for me this is something I would really object too for a number of reasons. I used the gass last time and was given a pethidine shot but it only kicked in after DS was born (he was rather faster than expected) so I know I should be able to make it.

I had heard that it is more painful with this type of issue though so I had thought that I might conceed to an epidural early on though that scares me too. I hadn't thought that I might need to feel the pain to help direct those around me as to what to or not to do. I must admit I was beyond talking for most of the birth so I don't know if I could tell anyone anything even if I did need to. Thank you for bringing it up as I can see it is something I will need to take into serious consideration.

On the CS side of things I don't know if you had all the pros and cons discussed with you so you may or may not be able to help. From what I understand if I didn't go for the elective CS but had an emergency CS because I couldn't get through the delivery on the day they would more than likely have to cut across the muscles that wrap around the front of the tummy area. From what seems like common sense but I did also ask the physio if they do this then it is that much harder to strengthen everything afterwards to help recovery. However if I did the elective so it wasn't rushed then they could move the muscles aside therefore not need to damage me as much (though it would still be fairly rough). Does this sound like anything they discussed with you at all?

I honestly don't know what to do about this. I know that for me any intervention apart from the pethidine and gass is more likely to panic and stress me out but I don't want my fears to make me choose a path that will cause more damage in the long run. I can see your point about the very same reasons why the joints are a problem being good for a normal birth as there is more room to move so that is a positive I will be taking on board.

Oh one other question, was there any consideration to induce or try have the baby before the due date (thinking at 37 weeks not 40) so that the size is not as large and so that hopefully you can start recovery sooner? I don't want to harm my baby but at the moment she is kind of harming me so its a bit of give and take. Seems kind of unfair that even though I am going through this she is sitting there 100% happy, healthy and fine - its a good thing but still rather frustrating.

Anyway thank you both for sharing, I couldn't use the link for the birth story but I'll have a bit of a search and try find it. I'll just have to see what to do next.

Diana

[alioops]

I tried to have an elective CS but my ob would not agree to it. In Emergency CS they do try to make the cut low still, especially considering that if you are in labour that is where bubs head is most likely to be.

We spent a heck of a lot of time discussing pros and cons with my ob and only when she said that she had been with a woman that had also been in a chair and that woman had delivered vaginally was I more coonfident. I did push for induction as I was not coping and my family support could not continue as mum had to go back to Adelaide to look after dad having eye surgery and MIL was in hospital so FIL had to go home too. I was induced at 39+2 and Leah was born in 2.5 hours. I had her half sitting up on the bed. She was tiny and only needed to go to the SCN for the codeine addiction. I was walking again gingerly and slowly 3 days later.

To find my birth story try doing a search for 'Leah Annabel' it should be the top thread

You may also be able to qualify for some in home care at a reduced rate through your hospital.

My physio recommended getting a good baby carrier, like a HAB for after birth so I could use my hands to support myself as needed and still carry her.

[AnyDream]

I got to the point where i probably should have been using a walking frame but I quit work early instead...the difference being that I didn't need to care for a small toddler at the same time. I was in the ACT at the time and I wasn't able to access any help/services so I took a very DIY approach to getting through.

I would really encourage you to take up some child care for your DS during the week. If money is an issue, you can apply for extra child care hours and "special child care benefit" which is where the service pays your part of the fees for up to 13 weeks (due to financial hardship, esp where cause by temporary illness, etc). If you don't like the child care centre environment, try family day care (run by communities at work in the ACT)- if you explain your circumstances they should try to find you a good carer quickly.

This really is a condition where it does not pay to 'push through' the pain/mobility etc - it WILL get worse if you do too much. You may however be able to stabilise this with good physio and your exercises & support gadgets etc - but only if you rest and don't do too much. If you're still able to drive & move short distances I recommend you get a temporary disabled parking sticker (I didn't do this but wish I had) - every way you can reduce how many steps you take in a day/how much standing/moving/carrying you do will help to reduce your pain and make it more bearable. My DH was away so I had to retain a certain level of functionality (or bust) so I did this by cutting every corner I could. I used a laundry trolley so I didn't have to carry the laundry basket. I put clothes thru the dryer whenever I could. I bought frozen or pre-cut veggie and bagged salads so I didn't have to sit/stand upright to get food on the table every night. I ordered internet groceries and got the man to carry the stuff into the kitchen and put the cold things close to the fridge etc.

I also second Maranui's layzboy suggestion. I didn't get mine until about 34 weeks (once DH was home again) BUT it was the first real attempt at comfortableness I'd had in months. You could look at hiring one of those comfy chairs with an electric lift mechanism in it as a temporary measure, I guess.

Let me just say, I love the positive help-yourself attitude you are taking to all of this. It can be incredibly difficult to deal with such a sudden mobility & pain problem when you are usually independent and self-sufficient. It helps to remind yourself that it's temporary, even if you need physio etc after the birth eventually you will get better.

[Majella]

Hi Mumintraining

I too can relate to your feelings here. I have had excrutiating pubic/sacral pain since about 20 weeks, and also had a trip to the emergency room because I couldn't stand it anymore. A few weeks ago I had to acknowledge that the pain and limitations in my movement, as well as the bad mood I was constantly in because of feeling so frustrated were making me depressed, which of course isn't good for anybody. Until I admitted this my OB was really unsympathetic and dismissed it as "one of those things". When I broke down in her office, she gave me prescriptions for painkillers (not my preference during pregnancy, but as you know you will do anything to stop the pain), and we discussed inducing at 38+ 5 or 39 weeks in order to limit the pain.

To try and get some relief I also did what Marydean did and cut corners where I could, did online shopping, made sure that everytime I stood up to do something I did three things so I wouldn't have to get up again, and bought out a stack of DVDs for my very active toddler. Yes, I felt/feel incredibly guilty for having to entertain DD by TV but for the short term it gives me an hour or so here and there to rest up.

To self-remedy, I bought a back support belt, went to the pool to do laps (don't do breast-stroke kick) or just get the feeling of weightlessness, went to a massage therapist, used heat packs, and have been taking panadeine forte on a daily basis. I also started pregnancy yoga with a qualified trainer who was able to tell me which excercises would help and hinder. Try to avoid pushing prams and trolleys because these can make things much worse.

At 34 weeks I had a day where things felt a little better, then day by day the pain became less. Two weeks later I am still in pain and am no where near feeling normal, but my mobility and mood are much much better. I'm not sure if this has come about because of the therapy or if, like Maranui suggested, growth has slowed down or the baby has shifted.

I'm not sure if there are any support groups out there, but feel free to lean on us anytime you need to.

I really hope you get some relief soon.
xx

[alioops]

Pelvic issues are often caused by malpositioning which explains for some the pain easing, but for many it doesn't settle and becomes worse, especially with subsequent babies.

[mumintraining]

I am in the process of trying to see where I can cut corners in my life. I am also trying to write down all the Mummy stuff I normally do so that I can pass this on to others - still don't know who other than DH yet but its good to feel like I am doing something.

Keep up the suggestions as I am taking it all on board. The not so funny part is that I was already dealing with Antenatal Anxiety and Depression and Hyper Emesis (thankfully that subsided just after 6mths so its manageable nausea). If I thought there was any way to do it without hurting the people I love I would really love to curl up under a rock and go into a coma - but that is not an option.

I am really trying to get DS into the TV but he just isn't interested (wow how many parents have that problem?) so I guess I will just have to get creative.

On the down side even with DH home looking after him ALL day DS still comes up to me crying and trying to climb up into my arms. I try doing the sitting in the chair thing which is kinda ok for him but its just heart breaking to have your child wanting your cuddles and you have to do like 100 little things before you can get to them.

Di

[fionas]

Hi mumintraining

I had this in my first pregnancy from Week 28 and for 18 months afterwards. I've had it from Week 7 in this pregnancy. By the time this baby is born, I will have been in pain for 30 out of 36 months so you could say it has dominated my life in recent times.

Do look into the special child care benefit that Marydean mentioned - or if you PM me your address, I will send you some info that another BB member sent to me.

Do everything you can to manage this and wherever you can, DO NOT STRUGGLE THROUGH.

I'm an example of struggling through it the first time in the mistaken belief that it would all go away after the birth.

Recently I found some overseas literature that recommended chiros who practice The Webster Technique reporting great results with women going from being wheelchair bound to pain free. I've found one close to me but haven't had chance to see her yet. Maybe Google and see if you can find one in your area.

I've found that I really have to be vigilant. At 7 weeks I was told I would soon be in a wheelchair. I have had to use a wheelchair since Week 12 instead of walking but by managing the condition as best I can, I've avoided having to use the wheelchair around the house.

I ice 3 times a day. This is important to get the inflammation down. However, I found in my first pregnancy that it didn't work at all. I think it was already so bad that a bit of icing here and there did no good. You might try icing for virtually the whole day if you can get someone to watch DS. It's also important to lie down as much as possible. SItting down isn't the same, ,my physio tells me as it's still working the pelvis.

Is the physio you're doing clinical pilates? I've found this to be really good and I do it 1-2 times per week.

Check out the Pelvic Instability Association - I found it good for letting me know that I wasn't alone and there are also some good tips on there but unfortunately no online or IRL forum apart from meetings that take place in Melbourne. There are UK sites, however, where people chat and it's good to read what's on there.

As for the birth, it's a really personal decision. Most people recover well, they really do and alioops is a great example. I'm a great example of someone who 'did everything wrong' in my birth and ended up with a disastrous result.

The key things are that you need to weigh up the drug situation carefully, need to make your carers aware that you have the problem and how wide you can comfortably open your legs, need to be careful with the position you push in AND ensure that you don't push for too long.

I've been in a real quandary about how to manage my forthcoming birth and had a chat with my physio that made things much clearer for me. Basically, she said that labour doesn't hurt the pelvis but the pushing stage does. The pushing stage in my first labour was almost three hours with my knees bent back and wide open against my chest (which didn't hurt at the time because I'd had an epidural) and finally resulted in forceps. All bad. Which is why it took 18 months to recover.

She said that if I want to go for a vaginal birth that I must use a safer position and must specify to my ob/midwives to only let me push for 20 mins max.

I'm not sure how your first birth was but I would suggest that as in alioops' case that if you had a short pushing stage for your first child then it would definitely be worth going for the VB.

My physio said that usually they recommend that people DO go for the VB because it generally does take longer to recover from a caesar in any case. With a caesar, they cut through the muscle and the muscle is important in supporting the pelvis.

However, there is no chance with a caesar of further harming the pelvis as there is with a protracted pushing stage.

So, for me, given that I had a long pushing stage with my first child and the fact that I would have to trust my caregivers would follow my wishes and put a time limit on pushing, I have decided to go for an elective caesar. I just don't want to worry for the entire pregnancy or through labour that my wishes will be followed. My physio tells me that best case scenario is that the muscles will have recovered by week 3 and worst case a couple of months - which to me is a walk in the park compared to 18 months last time.

So now that I've whittered on about my stuff, I just want to reiterate to you that you need to get as much help as possible and you need to consider your own circumstances and your previous birth, no-one else's. Taking every step you can to manage it now (primarily by resting) and during the birth will give you the greatest chance of having a fantastic recovery - and most women do recover well from this so don't let my doom and gloom put you off!

[nickle730]

Subscribing with interest...

I have suffered in both of my previous pg's and I've been told it gets worse each time

I found that physio several times a week helped, it at least enabled me to walk (hobble) around the house, but it didn't cure me of the excruciating pain! I don't think the belt really did anything for me.

I'm off to google the 'webster' technique.

Good luck, mumintraining, I'm sorry I can't offer a solution.

[AnyDream]

Do everything you can to manage this and wherever you can, DO NOT STRUGGLE THROUGH.

Absolutely , I think this is the single most important thing to take on board.