Tag: women’s issues

Sacroiliac Joint, Women's Health

Powerful female hormones, injuries, and pain

sunlight in winter

Something I’ve really come to notice during my time with SI joint issues is the effect of my hormonal cycle on my ligaments.

I saw a female pain specialist once who put it very plainly:

I have extremely healthy women come into my office– women who are runners, women who are training for marathons– and sometimes it seems like, during their period, all they have to do is bend over and tie their shoe, and they can throw their back out.

Why does this happen?

Basically, one of the hormones a woman’s body releases in the days leading up to her period is a hormone called relaxin.

As the names suggests, relaxin acts as a chemical messenger that tells our muscles and ligaments to relax.  Its main effect during childbirth is to cause the joints of the pelvis to become looser, meaning there is more room for the baby to pass through.

However, relaxin is also released during our menstrual cycle, beginning around day 14, so our bodies are prepared in the event that we do become pregnant.

And with more relaxin circulating in our bodies, our muscles and especially our ligaments are going to be a little more slack, meaning there is more risk for injury.

This article from BBC News outlines a few studies that have shown women are more likely to experience injuries in the second half of their menstrual cycles, due to higher relaxin concentrations.

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I have definitely noticed this going on in my own body.  For me, it begins 3-4 days before I get my period, right when I get my other PMS symptoms.  All of a sudden, I’ll feel my SI joints start to move around a lot, because my ligaments are not holding them in place as tightly.

There were times when I’d have to promise myself, in those days leading up to and during my period, that I wouldn’t judge my overall progress by the way things were at that moment in time.  (I’m sure my plummeting mood didn’t help with my gloomy outlook, either).

I’d really have to talk myself through, and say, I know things really seem that bad right now, but your joints ARE doing better.  Just wait a few days and see.

And then, sure thing, once my period had passed, things would go back to normal (or at least, back to baseline anyway).

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Since my SI joints are doing better now, I don’t notice quite the same extreme fluctuations in my level of function.  I have more muscle strength to hold things in place, and my ligaments have had more of chance to heal after my original injury.

However, every month, I can still feel things become a little looser, and my SI joints seem to have a wider range of motion (and not in a good way).

I also notice my hormonal fluctuations impacting other joints in my body as well.  I particularly notice it in my knees and in the joints of my fingers.  (That sounds totally random, but interestingly enough, finger joints were one of the joints that doctors studied, according to that BBC News article).

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So, for my female readers, this is something to be aware of.

If you are struggling with chronic pain, it might be worthwhile for you to track how your menstrual cycle impacts your pain.

I honestly was totally unaware of the connection, until that doctor suggested I start paying attention.

Once I knew, it did make things a little easier.  I learned not to freak out if things felt worse during a certain time of month, and instead knew to wait, and that it would probably pass (which it did every time).

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For more, check out this really informative article from Lindsay Matthews at Breaking Muscle on Relaxin: Facts Female Athletes Need to Know.

The BBC News article

I also just started using the Clue period tracker app.  It seems pretty easy to use so far.

Inspiration

A little optimism

sunlight in winter

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It’s been almost two weeks since my surgery, and I am finally starting to feel like myself again.  It’s actually amazing how normal I feel.

When I first got home from the hospital, I felt as though I was returning from another planet.  The extreme pain and sleep deprivation (due to pain before the surgery, and due to the extremely uncomfortable hospital bed after the surgery) had really played tricks on my mind, as had the shock of suddenly losing an ovary.

But I am back.  Still in some pain, and still playing catch-up on sleep, but back.

The weather this weekend was absolutely beautiful.  I had a relatively low-key weekend: visited my grandmother yesterday, and today had a nice afternoon drive with the guy I am dating.  (I don’t intend to get into my dating life too much on this blog, but yes, it is possible to have someone still be into you when your whole life is a mess and you can barely walk).

Anyway, I am feeling good right now, and I just wanted to share that with you all.  I may be walking around with one less internal organ than I was two weeks ago, but you’d never know it.  I feel totally normal.  I guess it’s true what all the doctors and nurses told me: that one ovary really can do the work of two.

Spring is almost here.  I can feel it.  The days are going to start getting longer and longer.  I heard bird calls today that I haven’t heard since the last warm days of fall.  The earth is beginning to warm again.  It’s going to be alright.

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I am so obsessed with the above photo.  It was posted under a Creative Commons Attribution-ShareAlike 2.0 Generic License… which basically means I can use it for any purpose as long as I give credit to emaspounder, who posted it on Flickr.  Thank you emaspounder… I have no idea who you are, but this photo inspires me so much.

Digestive Issues, Treatment Approaches, Women's Health

Beware the Red Herring

sunlight in winter

One of the reasons I sometimes take a critical tone towards alternative medicine on my blog is not always that I think these approaches have no merit.  But I do think that, too often, people are drawn to and waste their time treatments that are simply “fads.”

When I look back on everything that led up to my losing an ovary, I can’t help but feel my digestive problems are to blame.  I wasn’t sure I wanted to talk about my digestive issues on this blog, but what the heck.  I have issues with IBS and chronic constipation, made worse by the fact that I have a pelvic floor disorder.

I am so used to feeling discomfort in my abdomen that I didn’t rush to the hospital the moment things began to hurt.  In retrospect, that was critical time in which my ovary was being deprived of blood supply, and although the doctors and nurses I talked to didn’t want to come right out and say it, there is a chance I could have kept my ovary had I gone to the hospital sooner.

When I look back, I can see that some of the symptoms I associated with my twisted ovary were actually building for months.  I had this weird feeling in my right side, a feeling that something was where it shouldn’t be, for almost a year.

It’s so infuriating to realize this, because I talked to two gastroenterologists about the feeling that something new was wrong on my right side, that somehow things were getting worse.  I told my most recent doctor– who actually published a book on digestive issues in women– that I felt as though the right side of my abdomen always seemed to be a bit swollen (for lack of a better word). That my right side was always aching a little bit, that it was simply bigger than my left side.

This doctor basically told me not to try too hard to diagnose myself; that I shouldn’t go by how things felt from the outside.  I tried to explain that I wasn’t, but our appointment time was over and she had mentally checked out.

I am so frustrated now, because I wish she could have pointed just out that ovarian cysts can have many of the same symptoms of IBS.  Perhaps she could have said something like “Gee, I have no idea why that area is bothering you, perhaps you should try seeing someone in a different specialty.”

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I also wish I’d tried harder to get an answer.  It’s funny because, a few days before the pain really started up in earnest, I knew things were getting worse.  I didn’t have the horrible pain in my right side yet, but the feeling that something was there, that something was stuck, was really getting on my nerves more than usual.  I remember saying to my mom “I have to deal with this problem.  I can’t keep taking no for an answer.  I have to find a new gastroenterologist.”

Almost a year had gone by since I had seen a new doctor.  The last time I saw my doctor, which was almost a year ago now, she had offered to put me on Amitiza, a medication for chronic constipation.  I was reluctant to start a medication without exhausting every other possible option, so we decided that I would try going gluten-free first to see if it helped.

My doctor had said that sometimes it can take a long time for the gluten free diet to help.  She also said that it won’t necessarily work to just reduce gluten; you might have to eliminate it completely to really see an improvement.  So I spent the past year waiting to see if this would help.  At some point over the course of that year, my right ovary began to twist, and I did not aggressively pursue answers for the new pain I was feeling.

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Now, I am sure that a gluten-free diet has helped many people.  But at the same time, gluten-free diets for non-celiac sufferers is not something that has actually been proven to have any scientific merit (as far as I’m aware).

I think it was a mistake for me to have endured so much discomfort, for so long, waiting for something with so little evidence to help me.

When I look back over the years, I can actually see how sometimes, being stoic and just enduring the pain and discomfort has not served me well.  I’m sure certain family members of mine will get a good laugh out of this statement, but I wish I had complained more, not less.

Being stoic is not always good.  And neither is being too open to new ideas.  I had a very real, very diagnosable problem in my abdomen.  But I was content with no answers, for too long, because I was waiting to see if something that is basically a fad was going to help me.

Of course, I don’t mean this in any way to be a criticism of those who are on gluten-free diets.  If it helps you, that’s great.  I might even try it again in the future if my digestive symptoms don’t improve.

But it’s about proportionality.  When I look back, it just doesn’t seem logical; the idea that I could fix extreme discomfort by no longer eating something I had eaten comfortably for most of my life.  I can see why my doctor would have recommended a gluten-free diet for a more subtle condition.  A subtle treatment for a subtle condition.

But there was no proportionality between the persistent, nagging feeling that something was stuck in my abdomen, which bothered me day in and day out, that kept me awake when I tried to fall asleep at night… and gluten.  If gluten-free diets could clear up this kind of discomfort, I’m pretty sure they would be in medical textbooks by now.

So, these were my mistakes.  The first: a lack of proportionality.

The second: being too stoic.  I waited far too long for something with very little scientific credibility to help me, instead of insisting that a doctor understand exactly how miserable I am.

Let’s not be strong all the time, people.  Sometimes, it’s really important to just let yourself complain.

Uncategorized, Women's Health

So… I lost an ovary.

sunlight in winter

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Well, blogging friends, I still can’t believe this happened.  But this week, I lost my right ovary.

On Monday afternoon, I went to the emergency room with extreme abdominal pain in my lower right side.  It had been going on for almost 24 hours at that point.  At first I had thought it was just my chronic digestive problems acting up more than usual, but as time went by it became more and more painful, and harder to walk on my right leg.

I had never had anything go so seriously wrong with one of my internal organs before, and despite all of the pain, I still wasn’t expecting anything incredibly serious.  I am so used to dealing with pain and discomfort on a daily basis– to me, it’s just another part of the landscape.  I was just getting checked out to be sure.  I really thought they were going to send me home and tell me to follow up with my doctor.

They sent me in for an ultrasound, however, and from that point onwards the tone of everything changed.  Everyone started moving quickly.  I was told that my right ovary was swollen up to 7 centimeters, and that it had twisted inside of my abdomen.  Because of how it was twisted, the blood vessels that fed it were obstructed, and not enough blood was getting to it.

I don’t think more than an hour passed between the time the radiologist gave me my diagnosis and the point at which the mask was being placed over my face to knock me out before surgery.  Unfortunately, they weren’t able to save my ovary.

The two OB-gyn’s I saw at the hospital both reassured me that only having one ovary won’t affect my future fertility.  They said, contrary to what most people learn in sex ed, most women’s ovaries don’t take turns ovulating every month.  Instead, usually one ovary is dominant, releasing an egg every month– and if you lose that ovary, the other one can take over.  They promised me that many women live normal lives with only one ovary, and have kids, and reach menopause at a normal age.

But I still can’t believe this happened.  I am still waiting for some lab results to find out exactly what went on, but the doctors believe the reason my ovary twisted is because it had some sort of cyst on it weighing it down in a strange way.  This altered the way it was supposed to be anchored to my uterus, and caused it to twist.  The cyst on its own was probably nothing to worry about– many women get ovarian cysts on a regular basis– but because of its size, shape, and location, it managed to weigh down on my ovary in just the right way to get it to turn.

I can’t help feeling like maybe my ovary could have been saved if I hadn’t waited so long to go to the hospital.  All of the doctors and nurses I mentioned this to kept telling me not to blame myself, but I think they were just trying to spare my feelings.  Everything I’ve read since getting home emphasizes how important it is to get a diagnosis quickly.

I had simply never even heard of this before.  It’s hard for me to tell this story, but I wanted to put this information out there in case it can help someone else. If you ever have extreme or unusual abdominal pain, just go to the hospital.  Don’t wait it out like I did because you think it could be nothing, or because you don’t want to pay your high insurance deductible.  Just go.  Insurance costs be damned.  At least you might be able to keep more of your internal organs.

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Of course, as someone who really wants to have kids someday (not to mention going through menopause at a normal age) this is of course terrifying.  One ovary can supposedly do the work of two, but what happens if something happens to the second one?

There are two things I can do to protect my left ovary.

A) Take the birth control pill.  These cysts can form when an egg fails to leave the ovary.  If you’re on the pill, you stop ovulating, and no cysts can form. (At least not this type of cyst).

B) Go to the hospital for an ultrasound anytime I have pain in my lower left abdomen.  The doctor who performed the surgery said that in the future, all I will have to do is call her office and say I’m having abdominal pain, and they will set up an ultrasound at the hospital for me right away.

*****

That’s about it for this post.  Please ladies, don’t be like me.  Next time you are experiencing significant abdominal pain, go to the hospital RIGHT away.

The condition I had is known as ovarian torsion.  Check out this page for more information.

UPDATE: Three years later, I’m doing so much better than I thought I would be when I wrote this post.  It turns out that it’s true: you only need one ovary.  I am doing just fine, and I feel totally normal.

Thank you to Inspiration DC on Flickr for making the above photo available.