My mother wouldn’t want me to talk about this; not here, where everyone can see me. What isn’t pretty should be handled privately… or so she taught me, and her mom taught her, and so on and so forth. But the page is a place of connection. If I’m not fully present here, then what’s the point?
To put it bluntly, my organs are falling out. That’s a slight exaggeration. “Descending” is more accurate. However I frame it, it’s a disconcerting thought. My uterus, well, there’s a sign on that one that reads, “We’re done here!” But my bladder and my rectum, though performing their functions poorly, still seem necessary. I can’t have them planning their escapes.
The news of my organs descending surprised me. Like many women following childbirth, I’ve struggled with “peezing” (a word contributed by Liz Lemon from “30 Rock”) and other mild forms of stress incontinence for a long time. But since my mid-40s, those problems have intensified alongside a more troubling inability to defecate completely.
So after probing in hard-to-reach places, a urogynaecologist pronounces me prolapsed. According to a handout my doctor gave me by the American Urogynaecologic Society, pelvic organ prolapse, or POP, “occurs when the pelvic floor muscles and connective tissue weaken or tear. This causes the pelvic organs to fall downward into the vagina, similar to a hernia. Women may feel or see tissue coming out of the opening of their vagina as this progresses.”
POP can happen for a variety of reasons, among them muscle and nerve damage from pregnancy and childbirth, hormonal changes related to menopause, constant straining due to constipation, repeatedly lifting heavy objects and genetic predisposition.
To investigate the possible relationship between my prolapsing organs and my constipation, my doctor suggests that I undergo what feels like a new level of humiliation called a defecography. It’s not like a colonoscopy, where you theoretically sleep through the entire thing. In this case, medical professionals watch you poop while you are alert and fully present, live and on-camera. The test reveals whether there is some anatomical reason why you can’t eliminate properly.
I wonder if it’s worth it. Maybe I should just embrace my “pooping problem,” as my youngest calls it, and limp along without additional interventions. I can just live with the prolapses for now, right? It seems like the easiest and most peaceful route sometimes — just settling. But we all want more, don’t we? We want true healing. We want to feel better. We want to be fully restored.
I remain stubbornly curious about what could be, and schedule the test. But I give myself permission to say “no” the morning of — “no” when I get there and see what awaits me, “no” when they ask me to… you get the idea. I’ve never used the “no,” but having it emboldens me to be braver than I am.
“My doctor suggests that I undergo what feels like a new level of humiliation called a defecography. It’s not like a colonoscopy, where you theoretically sleep through the entire thing. In this case, medical professionals watch you poop while you are alert and fully present, live and on-camera.”
A defecography turns out to be as pleasant as it sounds. You suck down a bunch of barium and load yourself up vaginally with barium paste. The nurse then pages the radiologist: “The defo (that’s me) is ready.” She notices I’m listening to her — What else would I be doing? — and looks a little embarrassed. She apologises quickly for referring to me as “defo,” saying it’s only to prepare the radiologist for what he’s about to do. I guess referring to me as a person is too much work.
Then the radiologist arrives, explains the process, and inserts a large amount of barium paste into my rectum via syringe. If you have other anal issues like I do…a fissure, haemorrhoids, that last part is especially unpleasant. It’s hard not to feel violated unless your radiologist is gifted with an unusual amount of finesse. Mine was not.
Next is the fun part. You sit on an elevated platform sporting a special commode. With the radiologist and nurse next to you, you defecate on camera and on command. The radiologist stares at a screen to judge how well you eliminate and gathers evidence revealing why you cannot void completely. In my case, he found that my uterus descends and pinches off part of my rectum when I bear down, so I can only partially evacuate. Hooray? Maybe. I cry all the way home.
When I see my urogynaecologist several weeks later, she’s elated: “I’m so glad that I can do something to help you!” She’s a good doctor. She explains that she’d like to insert a silicone device called a pessary up into my vagina. It’s designed to hold up my uterus and prevent it from pinching off my rectum.
The pessary looks like a mushroom with a top that secures via suction and a long stem that extends down to my vaginal opening. Once I’ve assumed the position, she requests that I ready myself and relax. That doesn’t bode well. With significant force, she installs the medieval workhorse. According to the nurses, she “places” the pessary, but what I experience feels more like a pain-inducing shove. I arrive home feeling like I’ve got a tampon protruding and a little askew. I’m supposed to function like this for 2-3 weeks.
Unfortunately, the pessary changes nothing. The pooping problem persists. My urogynaecologist explains that she could still surgically fix the prolapses, pin up or remove my uterus, in hopes that stooling would improve. She looks at me: “What do you think we should do?”
My internal response is paradoxical. One part of me screams, What!?! YOU are supposed to be the expert! Why are you asking ME!?! The other ruminates, Thank you for acknowledging that I might have some wisdom to contribute.
“I’ll have to think about it.”
The end? Not really, and I hope not. But this is where we all are a lot of time. In between. In process. Unresolved. We all wander around hurting sometimes and can’t fix it. We’re all trying to make meaning of suffering while we wait for change.
But wherever this path takes me, I’m done with pretty and private. I’m done with the societal expectation that women’s bodies should look the same regardless of the trauma they have sustained, that aging should be invisible. My body is a ragged landscape of stories that I think I’m meant to tell. I am more than pretty. I am wildly, uncomfortably, unapologetically, fearfully resilient.
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