Preparing for Surgery – 2/15/2020

What do you notice about yourself when you read the words “preparing for surgery?”  What feelings come up? Fear. Anticipation. Excitement. Sadness. Depression. Empathy. Curiosity. Anxiety. Exasperation. What are your beliefs around surgery?

Preparing for Surgery

In 2008 I was diagnosed with POP (Pelvic Organ Prolapse). Simply put, it is the pelvic organs heading south because the pelvic floor muscles and tissues are giving up and letting the organs drop. I have never had pain or incontinence or any major limitations on my activities. The last 12 years were spent doing everything I know and  learned to stop the progression. Using a pessary worked great for a long time. Under my doctor’s care, I did biofeedback. I found Katy Bowman and diligently practiced every movement she said could strengthen my pelvic floor and learned more about Kegels. The more I strengthened those muscles, I thought, the more I could slow down the process. And, in fact, I think I did. One of the most effective exercises for me (mentioned in our book, Dynamic Aging @ p. 62) was learning how to walk with posterior push-off.

Pro-Active Preparation

Joan hiking
Joan hiking

Preparing for surgery can occur at multiple levels. One is nutrition. I reviewed my nutrition and made some minor adjustments to maximize the level of my excellent health to maintain my optimum weight and make sure I stay hydrated. Next I looked at movement. I am choosing to hike/walk daily focusing on posterior push off to keep those pelvic floor muscles involved for faster healing. And, I am doing Katy’s VSM (Virtual Studio Membership) classes at least three times a week. She has a great selection to choose from working all the parts of our bodies for whole-body health and mobility. I have a daily practice of meditation. And I got coaching (see below).

Medical Options

I have a great urogynecologist surgeon I have been seeing over the past 5 years relative to the POP. As the prolapse progressed, we tried different kinds of pessaries. Nothing worked for me and the one I was using began to erode tissue causing bleeding. When we began talking about surgical repair, she was forthcoming about explaining the various options and giving me her recommendations. Because of my age, and she acknowledged I am in excellent physical condition, she was unwilling to do a lengthy repair requiring me to be under general anesthesia for an extended period of time (4-5 hours). There are concerns about the possibility of  resulting cognitive impairment. She came up with two viable surgical repair options requiring less than two hours so I can either have a general or an epidural (regional).

I have all my original equipment and since it is healthy, she saw no reason to do a hysterectomy. Prolapse can involve different pelvic organs. Mine involves the bladder and rectum and the uterus to a lesser degree. The first option is repairing the bladder, rectum and uterus resulting in about a 1-1/2 inch lift. This is commonly referred to as an A & P (anterior and posterior vaginal wall repair). And over time, the prolapse can recur. Since my plan is to live healthy, active and productive to age 120, that is a consideration. The other option is called colpocleisis (vaginal closure). This has the highest success rate, is the quickest of the procedures available, is the least invasive and, it is my understanding, cannot be reversed.

Emotional Preparation

Joan climbing tree
Joan climbing tree

All the emotions I mentioned at the beginning of this blog post are possible. For me it is fear of the unknown. How will the surgery go? What will be the result? Will I recover back to where I am now? Physically will I be able to move like I do now (hiking and climbing trees among others). Will I be able to tolerate the pain with minimal drugs? What don’t I know? How will it affect my relationships with my husband of 45 years – the love of my life. Of course, there is no way to know the answers. However, getting clarity on my feelings made preparing for surgery easier emotionally.

Coaching for Clarity

Coaching helped me get in touch with my feelings. I got coaching on “fear of the unknown” to get clarity about my feelings and how to deal with them. By asking curious questions, listening to what I said and reflecting back what she heard, my coach facilitated my learning about the conversation going on in my head. It says grown-ups shouldn’t be afraid and if I prepare enough, I won’t need to be afraid. How do I prepare right now for the unknown? How do I deal with fear?  I discovered I have been ignoring a part of me that is really scared. By recognizing that part and choosing to honor and respect it, I can acknowledge the emotion each time it surfaces and let it move through me easing the way to facing the unknown.

Coaching and My Gifting Vision

100 People

My vision as a coach is to connect with at least 100 different people in 2020. I want to gift the experience of coaching by giving an introductory call. This is your opportunity for a win-win – support me in connecting and add  something to your 2020 Vision. How risky does that feel to you – the thought of emailing me and scheduling a coaching call just to see what it is like? Would that be a s-t-r-e-t-c-h for you? What is getting in the way of you taking that risk, sending that email? Could this be a first step in stepping out of your comfort zone and into a world of possibilities? You’ll never know unless you do it! And, I can help you discover and create your 2020 Vision through coaching.



  1. Empathy . That is what word and feeling wells up in me, for people I love who need to walk through medical procedures that will enable them to live better quality lives, for the rest of their lives. I walked this walk in 2011.You have done all that you can, whole heartedly, and now it is time for this. We are fortunate to live in times that these issues can be helped surgically. Wishing you the best, you are the best. Delia

  2. Wow, this is very eye-opening. I have similar issues and have been offered “fixes” that I don’t consider acceptable. I was offered a hysterectomy or mesh, and this was before I was 50. YIKES. I turned down both options, chose a pessary, and have sort of accepted that there are things I won’t be doing (lots of running) and that I’ll eventually have some kind of surgery. Have been putting off the choice, hoping that there will be new developments before I reach the point where I have to choose one. I have followed Katy’s advice with regard to walking/using the posterior chain, among other things. Maybe it has slowed the progression but it’s hard to tell. I’ll be waiting to see how your surgery goes, and if you are happy with the results. Best wishes for a speedy recovery!

  3. Joan,. Thanks for sharing this with us. I would imagine that many of us are in a similar age group as you and may be dealing with similar issues. Your thoughtful approach is so informative. May surgery go well and look forward to a follow-up post.

  4. Great post on a very personal issue. Thank you for sharing. I am confident that with all your physical, mental and emotional preparation that you will come through this current challenge with flying colors, Joan!

  5. Thanks for this blog, Joan. I want to say that I felt disappointed that you haven’t been able to “beat” the POP. I have been following you for a little while and thought that by keeping fit and active including the ‘push off’ way to walk that I could keep my POP at bay. I would be no where near as fit and active as you so if you haven’t been able to keep it at bay, it feels a little hopeless for me. Don’t mean to be negative but I just thought I was on the right track.

    1. Sandy, The purpose of this post is for information only. My results are not necessarily the same as another person’s. I am continuing to follow Katy’s excellent teachings to keep muscles toned and strengthened and supple and yielding. And this has worked for me in so many ways. I found another exercise Katy recommended that I am continuing to do to maximize my preparation – that is doing Kegels while squatting. I do the squat holding on to a doorknob so there is minimal downward pressure as I come back up. This exercise helps strengthen the gluteals and keeps all the supporting muscles in the right places while doing the Kegels. For more information, click on the link in the post for KEGELS. Feeling hopeless is a choice – so is never giving up hope:)

  6. I had the colpocleisis surgery 1 1/2 years ago. If you, or any of the blog readers decide to go that route I would be very happy to share my experience with you. I live near by in Meiners Oaks so we could meet for coffee/tea if you would like or just talk on the phone. Good luck- what ever you decide.

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