So I just finished doing 20 butterfly pullups on the bar and my arms are trembling. The next exercise is jumping rope with crisscrosses. This used to be fun and back when I was a kid, I even used to double-dutch. If I can get some ladies to do that with me now, I totally would!
I grab the rope and I’m jumping, I’m crisscrossing. 18, 19.
It becomes harder and I almost trip on the rope at 20 and again on 25. The goal is to make it to 50 but by the time I get to 35, it happens. I feel a warm leaking sensation between my thighs. I put the rope down and run to the bathroom. I look at my underwear and it’s moist. I’ve been having this issue ever since I gave birth to my daughter, she turns 4 next month.
I go back out there to my CrossFit class and do 20 situps. No more jumping for me.
I knew this would happen. Whenever I jump, my vagina slaps the floor. Kegel exercises are not enough because I’m not consistent. There are thousands of apps to help you do them but I ignore the reminders on my phone so it doesn’t help.
I finally decided to do something about my incontinence and I saw a gyno. The reason why it took me so long is because my regular gyno is a man; he delivered my girl but I don’t want him to look down there anymore. So I go into the Facebook Groups and find a female gyno. She tells me to do what I knew I had to do: Sign up for pelvic floor therapy.
In my first session, Dra Avila asked me a bunch of questions about my struggles with my incontinence and she asked me about my birth.
I’ve given birth to one child. The birth was vaginal, non-medicated, and without an epidural. I suspect that the reason why things loosed up so much down there was that when my doc measured me at 7 pm, I was 9 centimeters! My girl should arrive in two hours or less! But that didn’t happen. She was born the next day sometime after midnight. The reason for the delay was that the umbilical cord was wrapped around her neck twice which caused her to bungee in and out of my vagina.
Dra Avila said, “That should do it.”
The problem is that I didn’t know how to push! Whenever I got a contraction, I would push as if I had to poo, and yet, my vagina muscles remained dormant. The book said to push as if you’re pooing, the hypnobirthing video classes instructed that, too. TV makes it look like it’s part of our nature to push out human beings. It was not instinctual for me!
Dra Avila said, “Many pregnant women come here to learn how to manipulate their pelvic muscles in preparation for giving birth. When you do a poo, you’re not using all the muscles to push out the baby, you can actually mess things up down there if you don’t use them correctly. Not every woman is wired to know how to push a baby out, it’s not your fault.”
Well if my doula had told me that seeing a pelvic floor therapist BEFORE GIVING BIRTH would help reduce the chances of me getting incontinence, I certainly would’ve done that. I interviewed three doulas and none of them mentioned this detail. Did they not know? Is this not a thing?
She just shrugged as if to say, “Sorry, babe.”
After our conversation, I changed into a gown and sat upright on the medical bed.
Dra Avila inserted a harmless-looking device into my vagina and she instructed me to squeeze and relax my muscles. The monitor above me showed a graph with a curve shooting up and down. After 30 seconds, I felt a bit winded. But Dra Avila encouraged me to squeeze, to squeeze harder, and to hold it, hold, hold, hold. Release. Squeeze again, harder! Even though I got tired after a minute, I mustered up the last bit of energy in me and made the curve shoot up and out of the graph.
¡Eso! She yelled.
This all happened in Spanish of course. This is Medellin, Colombia. And if you’re wondering how much I paid, it’s the same as what you’d pay in California but in pesos of course.
190,000 COP for the initial session and the package of 10 sessions came out to less than 1,500,000 COP.
After the ray shot off the graph I wanted to cry.
Besides the incontinence, the aesthetics of my labial folds have also been a concern. The idea of labial rejuvenation surgery feels so artificial and I can’t talk about it with my husband because he has said many times that he likes how things look down there and to please, “Don’t point out any flaws because I don’t want to look for them.”
I recently became friends with a sex therapist and she loves talking about these things so I mentioned this to her but no one else.
Dra Avila said that there are four phases where she places her patients.
“If my patient is in phase four then I would recommend surgery. You’re in phase one so we can work together.”
She also gave my kegel exercise a score (which was below average) and assigned a goal.
After the 45-minute consultation, she gave me homework:
- Monitor your water intake. “I need to know how much fluid your bladder can hold.”
- Monitor your visits to the bathroom.
- Do kegel exercises three times a day. Whenever you squeeze, imagine the curve shooting up.
“One more thing,” she said. “You look fine down there. I’ve seen vaginas with such stretched-out labial folds that I have recommended surgery. If it really bothers you then I can recommend someone.”
Not sure why hearing that from somebody other than my husband put me at ease but it did.
I did these exercises for the next two weeks and the next time I lifted a 15 kg kettle ball, I pictured the graph with the curve shooting up.
Incontinence sucks. I’m 36 years old and I am in the best shape of my life. My weight used to oscillate around 120 lbs, but for the last eight months, it has dropped to 115 lbs, sometimes even lower. At the same time, I’m eating more, I’m drinking more freely on the weekends, I eat whatever the heck I want! I can carry my 35-pound toddler for blocks without cringing… but if I laugh too hard, squat too wide, or pick up anything too heavy (that is not my daughter) then I’ll feel a trickle. Sometimes while I’m watching TV it happens and I have to change my underwear.
As Dra Avila said, I am in phase one. The issue is not severe and I don’t trickle every day.
I wish I knew that this was something I could’ve prevented. To prepare for birth, I exercised till the week I gave birth. I ate everything, I did hypnobirthing. I thought I did everything but we could only do our best.
The picture I’m sharing here is of the exercises I did on my second appointment. I’ve signed up for 10 sessions and I’m going to go to as many as I can by June. It turns out that pelvic floor therapy is more than doing kegel exercises with a specialist. Maybe next time I’ll explain the rose session and tell you how Dra Avila stimulated a nerve in my calf to strengthen muscles in my vagina.
Where to Go For Pelvic Floor Therapy in Medellin
I’m pretty sure that there’s more than one pelvic therapist in Medellin so if you want someone who speaks English and she’s good, let us know in the comments! Otherwise, you can find my therapist, Dra. Lorena Avila Cardona, on Instagram @urofitmedellin. She only speaks Spanish and she helps both men and women. Her prices are subject to change.
Please tell her that Juana sent you. I send a lot of business to the businesses I mention in my blogs and I don’t get paid for it. However, they do appreciate it and I occasionally get special treatment for it ;-)
Pss! Want to know about how I gave birth in Medellin and found a doula? Then read this popular archive: Natural Birth in Colombia — How I Found My Doula
About me
I’m a serial expat from California working from my laptop since 2015. I gave birth to my daughter at a hospital in Medellin, Colombia, in 2019. My husband and I have been calling Medellin home since 2018. My hobbies include reading, watching good movies, tango, salsa, and watching good movies (sorry, none of that Marvel or Fast and the Furious fluff).
Follow me on Instagram @wanna.juana
