Family Forum / Pregnancy / Breastfeeding / September 2005

There is one problem with pregnancy and complications, in pregnancy you are
cared for my a midwife and if necessary an obstetrician, after pregnancy
your midwife cares for you and baby for 28 days and then it's back to
regular health care with your GP. So this means I hadn't seen my GP since
December until I saw him in July for the 6 week check. He knew that I had
pain issues during the pregnancy, but had not examined them himself, nor
taken a history. The plan was to see a physio at 6 weeks postpartum, which
eventually happened at 9 weeks postpartum, her examination revealed weak
muscles not working in the correct way around the hips and thus not
controlling the pelvis meaning it was still painful, but it also revealed
that my back was swollen around the sacro-iliac joints, as this was not the
case before the birth this indicated that the pain in that area was damage
being done during the birth and explains what I felt during delivery that
this area was being pulled apart.

The physio showed me some exercises to do, but unfortunately doing the
exercises seemed to vastly increased the SPD pain, so we had to reduce them,
by 3 months pp I had come to the conclusion that I needed more input,
whether that be help with pain relief or what I hadn't decided, until that
point I had just been taking over the counter cocodamol, ibuprofen would
have been excellent, but I am intolerant to it. So off I went to the doctor,
unfortunately the first time I went to see him he hadn't received a letter
from the physio and I didn't feel he grasped what the impact on me was, but
he prescribed a stronger dose of cocodamol, which has helped a little, but
not enough to enable me to do the exercises.

For some reason I felt afraid to go back to the doctor as I felt he wouldn't
understand etc. and wouldn't be able to do anything, but I realised that I
had to and that I had to really work on communicating clearly what my
problems were and this wasn't just an annoying pain, but a debilitating one.
DH is on annual leave this week, so I was able to go alone and was able to
very clearly communicate what was going on and he had also received the
letter from the physio. Unfortunately he is unable to prescribe any stronger
pain relief due to the breastfeeding, there is stuff that is ok one off, say
if you had an accident or an operation, but continual use can cause
problems. We decided that we would try a different NSAID, that I have
previously tolerated when given IM, that has been a bit of a saga as there
is a manufacturing problem at the moment and we've been unable to get the
correct dose, so the doctor had to fax through a prescription to the
pharmacy so they could give me the higher dose and even that wasn't in
stock. So I've had to cut a capsule in half to take a trial dose and see if
I can tolerate it, I'm definitely having side effects, but I think it will
take another few hours and possibly another dose to see if they are just bad
side effects or really me not being able to tolerate it.

He has also referred me to a rheumatologist, which surprised me, but then I
think they deal with soft tissue so it makes sense in some ways, but I would
have thought his initial idea would have been an orthopedic bod. This may
take a while, we will have to wait and see.

Also, the physio has referred me for hydrotherapy, she thinks there may be
exercises I can do in water that would not cause so much pain, but be
helpful, so I'm prepared to give it a try. The problem is, she doesn't want
to continue seeing me during that time, but wants me to continue attempting
the exercises, but it's getting longer and longer since she showed me them
and I'm nervous I am doing them wrong, so I've managed to convince her to
give me 1 more appointment and I'll have to try and explain that I feel I
need to see her fortnightly or something to keep an eye on things.

I've also started a postnatal exercise in water class, I don't think it is
helping with the specific problem but it is good fun and I am sure it will
help me in other ways, the first time I found that standing in the water for
half an hour was too much weight bearing, so now I'm doing the exercises
balancing on a long thin float between my legs, which occasionally has
hilarious results when I suddenly topple over. I've also started a pilates
class, which is similar, not helping specifically, but helping generally, I
am surprised by quite how many of the exercises I can't do though :-(.

So that's it, that is where I am at, sorry it's so long, but I thought it
was time to give a clear update, rather than just odd allusions to ongoing
problems.

Anne