My poor abdominals.
Two ginormous pregnancies have pushed them to their breaking point (literally).
And in two days I’ll be having surgery to fix them.
I know…shocking, considering my last diastasis update was like a year and a half ago and at that time everything seemed to be going so well. But everything’s sort of happened really quickly, so I’ll give you the run down.
By “fix,” I mean I’ll be undergoing an abdominal diastasis repair and an umbilical hernia repair, meaning my intestines will be pushed back to where they’re supposed to be, the tear in my stomach tissue will be repaired, and then my abdominal muscles will be sewn back together.
Yes, I found out last month that I also have an umbilical hernia, a common follow-on condition of diastasis recti.
But let’s rewind for a second, because this story has been about five years in the making.
If you want the long winded version, you can check out the post I wrote a year and a half ago when I got really serious about closing the big ol’ gap between my abdominal muscles, which really goes in depth about what diastasis recti is, how it’s developed, how to diagnose it, and my own personal experiences living with it.
But for the quick and dirty explanation of what the heck I’m talking about:
Diastasis recti (Diastasis = “separation”, Recti = “front abdominal muscles”) is the weakening and/or thinning of the connective tissue (the linea alba) that connects the parallel sides of the rectus abdominis muscle, which causes the rectus abdominis to separate.
Everyone has a small gap between those halves, but many things (namely pregnancy) can cause that tissue to weaken and stretch beyond repair. I developed it after my first pregnancy, but didn’t even realize that my abs had separated until about a year and a half later. Checking for it is super easy, and upon discovering I had a two finger-width gap (about 2cm or 3/4″) I began to understand why I still looked like I was about four months pregnant a year and a half post-partum; my insides were literally pushing their way out.
I’ll admit, when I first discovered I had an abdominal diastasis I was pretty adamant about the fact that I was going to fix this thing the natural way; surgery was the lazy (wo)man’s way out.
After my second baby was born, I got really serious about closing the gap, which had grown to about 3 fingers-width (about 3.5cm or 1.5″), and I was “100% confident” (my own words) I could take care of it myself.
So I bought the MuTu System. I performed “safe” abdominal exercises daily. I stretched religiously. I became aware of the pressure my posture was putting on my abdomen. I made sure to always protect my core by lifting with my legs, never sitting straight up out of bed (always roll to the side, then sit up), and ceasing to perform crunches, planks, push-ups, sit-ups; I even quit CrossFit. In an attempt to heal my weak connective tissue I started drinking collagen infused smoothies (yes…beef collagen smoothies…). I focused on eating foods full of vitamin C and E and Zinc and copper. I upped my vitamin dosage and diligently took glucosamine and chondroitin supplements.
8 weeks later and I saw no measurable progress.
So I decided to take things to the next level and began meeting with a physical therapist who specialized in pelvic floor issues and post-partum rehab (post on that here), and I will say, after about a month my therapist actually noted about a one finger reduction in gap width (back down to two fingers…yay!).
But don’t get too excited, because the joy didn’t last.
While PT was great, it wasn’t a viable long-term solution for me. I was meeting with my therapist three times per week for an hour each session, and I won’t lie, therapy was like a mini-vacation for me (no screaming kids for an hour? yes please). But as a mom with two littles and a husband who works and friends who can’t babysit my kids two hours a day three times a week and hobbies outside of chilling at the therapist’s office, it just wasn’t feasible to keep it up.
So for a good month or so after I left therapy I continued doing the exercises as diligently as I could, but one hour a day turned into 45 minutes a day which later turned into half hour a day which eventually turned into I can’t lay on the floor without two kids dog piling on top of me okay yeah this isn’t happening maybe I can cram in five minutes after they go to sleep and I pass out for the night…
Long story short, after I quit going to therapy, life happened and that gap went right back to where it started and then some.
As of today, I currently have just shy of a four finger-width gap; just under 5 CM or 2 INCHES.
Make the number four with your hand, folks…
Note the distance from your pinky to your index finger…
THAT IS THE SIZE OF THE GAP BETWEEN THE LEFT SIDE OF MY ABS AND THE RIGHT SIDE OF MY ABS…
Which means all of those awesome innards and organs are makin’ a break for it. Literally.
In the beginning the issues with my diastasis were largely cosmetic; as a former six pack owner, I hate the way my stomach looks, not even gonna lie. Granted it’s only happened to me once, but earlier this year I was asked how far along I was and it crushed me; suffice it to say, my entire wardrobe consists of large, flowy, stomach-hiding shirts.
But vanity aside, I’ve had significant lower back pain since my second baby was born, and in the last six months or so I’ve developed abdominal pain.
I feel it any time I bend over or my stomach really goes loose, like when I’m bending to give my kids a bath or when I lay on my side at night; but it’s most severe when I do anything that really jars my stomach, like cough, sneeze, or laugh really hard.
So in October I scheduled appointments with a plastic surgeon and a general surgeon to see what my options were for getting my diastasis fixed once and for all.
What did I find out?
Firstly, I was relieved to be told by a competent medical professional that when the linea alba has been stretched so substantially, it will NOT regain functional elasticity and NO amount of safe exercise will close that abdominal gap. For four years I kept thinking if I just worked harder I could make this whole thing go away, and felt really disappointed in myself that it wasn’t. To be honest, my own midwife knew nothing about how to treat diastasis recti (he told me to do crunches…FYI, don’t do crunches). A lot of resources out there tell you that if you just buy their system or belly band or supplements you can close the gap. My family physician admitted he had no clue what to do and just sent me to the physical therapist.
In the end, it was actually very liberating to be told that this was something I simply couldn’t fix on my own.
And secondly, I was told that I also had an umbilical hernia. It was a little surprising, but it made perfect sense (so that’s why my belly button defies the laws of gravity and points at the floor…). When the plastic surgeon asked what the diastasis felt like, I told her that it felt like my guts were spilling out. She immediately followed that up with, “Well, they are…literally.”
If you don’t know (I didn’t), a hernia exists when an organ pushes through a hole or weak spot of the muscle or tissue that normally holds it in place; in my case, some intestine has pushed through a weak spot near my belly button (sorry, I hope you weren’t eating dinner just now…).
A diastasis on its own isn’t a serious medical condition (although it does cause pain and discomfort), but a hernia can become one very quickly, and small hernias are actually more dangerous than large ones, as the displaced bowel is more likely to become strangulated. While there were many reasons I initially considered either postponing or foregoing the diastasis surgery altogether (ie: the fact that most insurance companies won’t cover it (I’ll talk more about that debacle in another post), the fact that I live in China, or the fact that I’m planning to compete at the IRONMAN championships in Kona next October), I knew I needed to get the hernia fixed ASAP, and my surgeon strongly recommended I have the abdominal muscles fixed as well to prevent the hernia from recurring.
So, how am I feeling?
A little nervous, I won’t lie. My surgeon told me to prepare to feel like I’ve been hit by a bus. The surgery will take about four hours and I’ll spend one night in the hospital. I’ll have drains in my abdominal cavity for about a week and am a bit nervous about how our house is going to function with me down and out.
But I’m super confident and comfortable with my surgeon and the international hospital I’ll be having surgery in. We also have a great ayi who’s going to be helping us this next week and incredible friends who are already planning meals and playdates for our kids for the next two weeks.
And I’m also relieved. And SO excited.
I’m looking forward to feeling like my insides are no longer going to fall out through my stomach. To laying down and not having discomfort every night before I fall asleep. To picking up my kids and having no pain in my abdomen. To doing sit-ups. And push-ups. And planks. To not having to hide my buddha belly behind large flowy shirts. To not being asked if I’m pregnant. To having core strength again.
To being healthy.
I’ll give you more updates as things progress. One of my biggest frustrations through this process was struggling to find information from others who’d had these issues or this surgery, so I’ll try to post as many details as I can. If you have questions don’t hesitate to reach out.