Anyone else have no luck with GP taking pelvic pain seriously?

[dusashroom]

I am 16 weeks +5 days pregnant. I have been pregnant 3 times previously with no success - diagnosed with blood clotting problem. So when I started to feel sore, I ignored it as it was not the super worrying pain that I was terrified of.

I have a family history of pelvic girdle pain (or symphysis pubis dysfunction as it was called) and so when I mentioned how I felt, I instantly got an answer from my mum (after 2 weeks of pain between the legs and shooting down one leg when moving).

So I called the midwife - who was quite understanding but told me that only GPs can refer to physiotherapy now. When I saw the GP I was told to only worry about UTIs or miscarriage and, although there is no discomfort when urinating and no back pain I agreed to have tests for UTIs. I was in severe pain for 40 minutes after swab was taken because of how far apart my legs went. So I was told to not go in to work until the results come back and if it is all clear then do not worry.

Spoke to midwife again who offered to send me an information leaflet and said to try the GP again, explaining about physiotherapy as a referral takes time and sooner treatment is better.

I then saw a different GP who told me that discomfort is normal and physiotherapy is "not an option" while pregnant - maybe a referral after giving birth is an option. He also told me that by taking painkillers I am risking my baby's life and if it is really that bad to go to A&E and see a gynaecologist.

So now, I cannot go to the bathroom in my house as it is upstairs and the pain is so severe when walking upstairs that I lose control of my bladder (and sometimes throw up).

I have had to give up on the idea of working because I cannot even stand up straight and have quite an active job. I get sore laying down in any position and so I am not sleeping well.

I cannot find a local physiotherapist who mentions pelvic pain or treating pregnant women on their information.

So should I keep harassing the GP, try to move to a different area (lovely family, partner might not agree though), try finding a private physiotherapist who will travel or give in and do the bed rest/not moving thing for 20 weeks?

[Kaley]

I think you should do as the GP said and get into the hospital system via A+E. That should get you the car you need. You shouldn't be suffering like that, it's really not fair. Good luck with it. X

[Carren]

Sorry to hear you're in such a bad way and getting so little support. I've got SPD and had a different but equally useless interaction with the GP about it. I didn't know what the pain was at first and just assumed it was normal aches and pains until one day it was suddenly so bad I could barely walk, so I got scared and phoned the triage nurse, who diagnosed SPD over the phone and suggested I get a support belt and speak to my midwife at my next appointment. My midwife then sent me to the GP to get a referral for physio, and the GP, well, panicked basically, and sent me to hospital. He called ahead and was told not to, but did anyway. I don't know what he was afraid might be wrong with me, or even if he knew what he was afraid might be wrong with me, but he didn't want to be responsible for sending a pregnant woman in pain home without doing anything. He insisted I needed to see an obstetrician, but of course that was never going to happen, as consultants have staff who make sure their time isn't wasted by people they can't help. I was seen by another midwife at hospital, who just rolled her eyes when I told her my story and said that GPs don't learn very much about pregnancy in medical school, so can be pretty useless.

Anyway, about a week and a half after that wild goose chase I saw the physio, and the good or bad news, depending on how you look at it in light of your difficulty getting a referral, is that there isn't really anything a physio can do for SPD besides talk you through what you should and shouldn't do and give you a catalogue to order support belts from. There are no special exercises or manipulations the physio can do with you that will make the situation any better. I personally found it comforting to speak to a professional about it, because I had become so scared of making it worse that I'd practically stopped moving altogether, and he gave me the confidence to carry on with some very easy pregnant-lady pilates and my aquanatal class. However, he didn't have any information to offer that isn't freely available on the internet, so if you fail to get a referral, you should still be able to take steps to help yourself.

Here, in no particular order, is what I've picked up so far info-wise:

There are basically three levels of kit you can get to help you: support belt, crutches, and wheelchair. The support belt you have to procure for yourself as the NHS no longer fund them, but they're not expensive. Crutches or a wheelchair you get from your GP. If you haven't tried a support belt yet, do please get yourself one ASAP, they are truly amazing. When I first got mine it almost completely alleviated my pain. As time went on and the pain got worse, it no longer did the trick fully, but I'm still a lot more comfortable wearing it than not. I've got this belt: mothercare.com/Nexcare-Mate..., which is designed to lift your bump up to take weight off your pelvis. You don't feel very sexy in it, but I'll wager you're past caring about that. The physio also mentioned that you can get belts designed to squeeze everything inward, and I've heard and read that a lot of women found them to work wonders. Just make sure whatever you get, it's a proper piece of kit designed to do some real work. Mothercare also carry some cheaper belts that look like glorified bump bands, but according to the knowledgeable saleswoman who helped me, they're pretty much useless.

Obviously try to avoid doing things that make the pain worse if you can. My midwife told me that the worse it got before I gave birth, the longer it would take me to recover after the birth, so it's worth taking it easy. If you do a quick google you'll find all the basic tips such as not spreading your legs too far apart, sitting down to put on your trousers, getting in and out of the car two legs at a time, etc., but as far as I can tell, every woman with this problem experiences it a bit differently, so what's good or bad for me may not be good or bad for you.

Despite what the triage nurse and hospital midwife told me, it can get better. I discovered as things got worse that my main pain trigger that I hadn't already eliminated was sitting down. I can lie on my side comfortably, and I can stand comfortably, but if I sit down for more than half an hour, I'll be in pain when I stand up and try to walk or go up and down stairs. I was on the verge of breaking down and requesting the crutches, but I decided to give working from home twice a week a try first. I've got a desk job, so I can do it lying down in bed with my laptop, and even though I've only been in my new routine for a fortnight, I've already gone from being in excruciating pain a lot of the time to just having a dull ache some of the time. Even on the days when I do go into the office I'm alright, because I don't have the cumulative effect of 5 days in a row of continuous sitting to contend with. I can even go down a flight of stairs without concerned colleagues attempting to rush to my aid! Anyway, obviously that exact approach isn’t going to work for you, because you can’t work from bed and even if you could, it doesn’t sound like you’d be comfortable there. Still, every woman’s pain is different (I think it depends a lot on which ligaments in your pelvis go—for me it’s the ones in the front middle), so maybe if you persevere you can find some way of taking the pressure off.

Water is great. I go to aquanatal once a week and “swimming” (more like gently bobbing up and down to be honest) once a week when I can, and the pain just goes away when I’m in the pool. Just remember if you do a class make sure the instructor understands SPD and can safely modify the exercises for you, and don’t get carried away and do things in the pool that you wouldn’t out of the pool, like spreading your legs, e.g. to do the breast stroke. It’s easy to accidentally overextend yourself in the excitement of the pain-free moment, but you’ll regret it later.

You need to be careful while actually giving birth not to stretch too far. Be sure to discuss this in detail with your midwife when you do your birth plan, and make sure everyone who attends you knows what to do and what not to do. As you found out when you had your swab taken, a doctor who doesn’t understand your limitations can do a lot of damage. The physio told me to check weekly how far apart I could comfortably spread my legs so I could tell the midwife when the time came, and if you get an epidural, definitely take an accurate measurement of that distance beforehand, because you won’t be able to feel the damage you’re doing by spreading your legs once you go numb.

Finally, what you were told by the second GP doesn’t make sense. Paracetamol is safe during pregnancy as long as you don’t take more than the recommended dose, though to be honest with you, I didn’t find that it made any difference for me. You can also take cocodamol, though you’d want to discuss that with a doctor first. I think the safe dosage may be lower for pregnant women that non-pregnant women. I personally haven’t tried that yet because I’m still working and driving and don’t want to take anything that might make me loopy, but with the amount of pain you’re suffering through, it might be worth considering. So obviously no ibuprofen or anything like that, but you do have pain-relief options. Also, forget going to A&E unless you think something else besides your SPD might be wrong, because there’s nothing they can do for you there besides keep you sitting around for hours in an uncomfortable chair making your pain even worse.

I’ve droned on long enough now that you could be forgiven for not making it this far. I hope I’ve said at least one helpful thing. Good luck and I hope you find some relief soon!