In what was a devastating turn of events, my OB/GYN, who’s literally my ride-or-die for hooha care, informed me at my annual exam that she could see my bladder. Yup. Actually see it.
“What?” I asked, sitting up instantly, my visit going from my first minutes of tranquil solitude in months to a brutal reminder that forty, and all its consequences, was right around the corner. (Okay. Forty actually already passed, but I don’t know any of you, so I can pretend otherwise, and just write as if I am perpetually in my thirties. Next article I might even be in my twenties.)
“Yup, stage 2 prolapse for certain,” she said. “Do you want to see it?”
“No, I do not want to see it.,” I said. Why would I want to see the evidentiary proof of my vagina’s collapse? “But, what does this mean?” I asked.
“Well, are you going to the bathroom frequently, or straining while going?” she asked.
“Hmm.” I hadn’t really thought much about it. I had noticed waking every night, and not making it on long car rides (sometimes not even making it on short ones). But I had assumed it was something temporary that would fix over time, like the linea de negra that’s still slowly fading on my belly, or the thirty pounds of baby weight I was losing at a rate of .25 pound a month. “Is this a problem?” I asked.
“At your age, it’s not good. But, don’t worry. You can always have it surgically lifted back into your body,” she said.
What, what now? Lift it back into my body. Wasn’t that the same procedure my seventy-year-old mother-in-law had last year? How did I get here so soon? Sensing my hesitation, she suggested pelvic floor therapy instead.
“It will help strengthen the muscles,” she said. As she spoke, I felt the urge to pee, but I pushed it back. Why face reality when I can just pretend it doesn’t exist?
Parenthood had stolen a lot of things from me, my tiny waist (okay I never really had a tiny waist but again for the purpose of this article, let’s pretend I did), my perfectly polished fingernails, the ability to wear pants without elastic waist bands, my perky bosom (okay, they were never really perky either), and I had accepted all of that in exchange for my adorable bundles of joy. But my bladder? This seemed too much to process. I had always been so fond of it. Proud of it even. How much it could hold on transatlantic flights. How quickly it could empty. Others had even commented on it in public restrooms, saying things like “Wow, you go so quickly.” That part is hand to God true. I would never lie about my bladder.
Now all that was ending. It was perfectly in place for all these years, and suddenly it was slipping away, that first sign that I was hitting middle age. I wasn’t prepared to accept this reality. I pledged to make it right, and to correct the wrong that my three pregnancies had done to my poor bladder, who had been nothing but a supportive friend over the years. So, after eating a half a box of Oreos, I signed up for pelvic floor therapy.
When I entered the building, at first glance, it seemed calm and soothing. The spa smelled like lavender, and there was a waterfall flowing down the wall behind the receptionist. The receptionist barely whispered as she handed me forms to fill out, and assured me there was no rush and to fill them out at my leisure. According to the pamphlet, I would embark on a journey of exercises to train my pelvic floor muscles to actually hold my bladder in place, to regain the ability to run without dribbling (and I don’t mean a basketball).
I handed the receptionist the forms and moments later a lady came to take me back. She was a smaller lady, maybe 5’1 and 100 pounds. She walked on her tiptoes, and seemed to float in her Skecher sneakers. She talked while we walked, which always unsettles me. Friendly people can be daunting sometimes.
“So, I’m Mrs. G., are you excited to get started?” she said.
“Depends, Mrs. G. Depends.” I snickered at my joke, which she didn’t seem to get. She went over some introductory questions asking about what brought me there today.
“My doctor says I have a prolapse,” I said.
“And are you incontinent?” she asked
“You mean like my grandma?” I questioned. The label seemed dirty, like I’ve done something wrong. And maybe I had. The third child might have been a bit much, and it did seem to be the straw that broke my bladder’s back.
“It’s okay to admit it,” she said.
I do pee myself all the time, and wake frequently at night, but I couldn’t admit it. It seemed private and shameful.
“Well, let me tell you about pelvic floor therapy. What we are trying to do is strengthen the muscles that hold your bladder up.” She pulled a small rubber chicken out of her desk. “You see what happens over time and after childbirth, is these muscles weaken and with gravity, the bladder is pulled down. Let me show you,” she said. She squeezed the chicken until a sack came out of its’ bottom. “Now, that’s what happening to your bladder.”
She asked me to hop on the table to show me some exercises. She said to lay flat on my back with my knees up and bent, pelvis tilted. “Okay, so what you are going to do, is tilt your pelvis, and squeeze those muscles. Now, I want you to inhale. Raise your pelvis up. Squeeze those muscles for five seconds while exhaling. Release. Lower yourself. Inhale.”
“You think you got that?”
“Yes,” I said lying.
“Tilt. Inhale. Raise. Squeeze. Exhale. Release. Inhale,” she said, while I followed along terrified that I was going to exhale on an inhale and release on a squeeze. Within minutes, I was in a full sweat. This was no day at the spa.
“Okay, good. Now I want you to pretend your vagina is a straw, and that it’s trying to suck up a milkshake. Just suck as hard as you can,” she said, resting her tiny hand on my gigantic arm.
In my life, I’ve pretended my vagina was a lot of things, but never a straw. I tried to suck my hardest, but I felt so much pressure (and not just from my bladder). She kept asking, “Are you sucking hard enough?” But I just couldn’t suck anymore. My pelvic floor was having performance anxiety. I felt instantly sad and full of defeat. I wanted to give up. I didn’t really need this. Or did I?
When I left, I called my husband for moral support. “The lesson is always don’t have kids,” he said. “How big a deal could this really be that you have to go to therapy for it? You are making a mountain out of a molehill.” It’s not clear why I expected support. His bladder, after all, is still properly placed so he cannot relate. But ultimately it was a big deal. I’m 29 — eh, 40 —years old and I wake to pee at least once, sometimes twice a night. I can’t run anywhere except around my cul-de-sac because ten minutes into running I always have to stop and pee. I know every gas station in a ten-mile radius of my home.
“I’m incontinent and it’s affecting my quality of life,” I said to him, lifting my shoulders back, proud to finally be able to admit the truth. “Can I hang up now?” he asked, not at all affected by my revelation. “Whatever,” I said. I rewarded myself with the other half of the box of Oreos, sat back and said I can do this: “Tilt. Inhale. Raise. Squeeze. Release. Exhale.” I have, however, had to switch from milkshakes to ice cream cones.