Thursday, 14 January 2016

The Pain of Symphysis Pubis Dysfunction (SPD)

I am now on my last few weeks before the arrival of baby#2. Suffice to say that I am still so not ready...

Anyway, something else to share is that last Saturday night I just could not walk without crying as the pain was so bad. I didn't know what I did or didn't do  and where was the pain was actually. The minute I tried to stand and put one foot in front of the other, the stabbing excruciating pain in my back, groin and panty line area would come. Coupled with the really heavy feeling of baby pressing downwards on my vaginal area. I could not lie down comfortably either and the only position that offered a little relief was sitting upright on a chair.

Slept really badly on Saturday night and come Sunday morning, it was even worse! I literally cried and cried every time I moved and finally decided to go see Dr Tan. I really thank God that she has clinic hours everyday of the week including Sunday and when I called, the nurses there asked me to come in as soon as possible.

So we quickly got ready, packed Chapati in the car and drove straight there. It was torture to climb the stairs to her clinic and by the time I got to the front door, I was in tears again. I couldn't move to the toilet to pee for the urine test, much less walk to the back of her clinic for an ultrasound. I was crying from the pain and the nurses quickly bumped me up the line (I think) to see Dr Tan soonest. I explained to her what I was feeling and after hearing me out, she put her hand just below my belly where your pubic hair grows and pressed. It HURT! Badly! She then explained to me in simple English, that my pelvic bones seem to have separated more than it is supposed to at the stage of pregnancy that I am at. This normally happens closer to the time that baby is due to come out but I was only 36 weeks plus. Because of that, my pelvic bones move too much and thus the pain. Which she said could be excruciatingly painful (which was really bad in my case) She also explained that some times, mothers experience this pain as well after birth. In any case, she prescribed rest for two whole weeks or until I deliver.

I was of course horrified! This is the beginning of our new financial year at work and the first month! Appraisals were due this week and so was our quarterly workshop! I still had so many things going on at work that I took it for granted I had another two weeks to clear stuff up.

The nurses then brought me a wheelchair and we found out that her clinic area has lift access and they kindly arranged for an access card to allow Hubby to drive to the basement where I could be picked up. If only I knew, I would NOT have attempted the stairs in the first place.

On the way home, I called Doc sis in the USA and explained to her what happened and she explained my condition in a little more detail. She also gave me the name of this condition to look up so that I could understand what was happening to me. Symphysis Pubis Dysfunction...yeah a real mouthful.



This picture explains it a little better.

I like how this What To Expect website explains Symphysis Pubis Dysfunction.

"Symphysis pubis dysfunction, or SPD, means the ligaments that normally keep your pelvic bone aligned during pregnancy become too relaxed and stretchy too soon before birth (as delivery nears, things are supposed to start loosening up). This, in turn, can make the pelvic joint — aka the symphysis pubis — unstable, causing some pretty strange sensations and sometimes pelvic pain."

In my case it was acute and piercing pain when I stand and try to walk.

There is a bit more material on Wikipedia and another website called Birthsource.com. The article in Birthsource touched a little bit on delivery which was helpful to know.

"Birthing vaginally is certainly attainable and preferable even with SPD. Spreading of the legs, however, should not be extreme. Perhaps the best positions for pushing when you have SPD is either "all-fours" (hands and knees) or side-lying. Squatting may be painful as well as the most common birthing position, the sitting position with legs wide apart. Be sure that you explain to the nurses and other caregivers that you have symphysis pubis separation and need to minimize spreading your legs widely. One of the drawbacks of receiving an epidural during the birth is the pain of separation may be masked and therefore you may be put into positions that are only making the problem worse. Unfortunately, you wouldn't find this out until the anesthesia wears off and you have the extreme pelvic pain. Therefore, it is imperative that the caregivers know of your condition and do not suggest positions that could exacerbate the situation."

So now, it's for me to "enjoy" this time off to myself, though I reckon that it will be a little difficult due to the fact that I am working from home. (Thanks to technology...NOT!) But the last few days of limiting movements, because I am at home, has really helped to reduce the pain and discomfort tremendously. Now just a little more research to do on delivery positions, I really don't want to suffer post delivery.

Mummies! Please do share experiences and resources if you suffer from SPD too. 

Update: 17th January 2016

My bill for this emergency visit.

Consultation    = RM80.00
Pharmacy        = RM20.00 (10 tabs of Ultracet (tramadol + paracetamol)


Though I am wondering why she prescribed me Ultracet as I did some research on the drugs and they are category C. Lots of recommendations that it should not be taken during pregnancy & breast feeding. Thank God, I only took 1 tab the other day as I really wanted to lie down without pain. I don't plan to take anymore unless I am really in a lot of pain.

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