It makes no sense.

A shattered coconut on the middle of a residential street on an April morning in Northern Virginia.  Admit it.  It’s weird.

My 6 year old noticed remains of the coconut on our walk to the office during the 1st weeks of the pandemic.
(She came to work with me twice each week for 14 consecutive weeks…not sure if she’s brave, tolerant or a saint).

Mama, why is there a coconut on our street?

I have no idea dear.

We made up funny stories. A monkey dropped it on his way to work; it flew out of an airplane coming from the Bahamas (she was clearly missing our annual spring break trip cancelled courtesy of COVID). There should be a cream pie around here somewhere, right?  It was a funny sight & we thought nothing of it afterwards.

Until it happened again.

And again.
And again.

For the past 5 months I’ve found a broken coconut at the intersection of our street at least a half-dozen times. An unsuspecting car usually finishes it off, crushing it into manageable tasty bites for the local squirrels. I almost expect them to break out into a conga & do the macarena.

What’s going on?  It makes no sense.Why do I leak when I get up quickly to grab a toddler heading towards an ungated stairwell but not when I cough?

Why can I jump rope without symptoms but the second I start to run I have problems?

Why can I use a tampon but sex hurts?

To me it’s clear as day.

So much of what we experience postpartum doesn’t make sense.  It probably doesn’t make sense to you, either, especially if it’s new or unexpected.

These are patterns I’ve seen for years.

The bio-mechanical challenges & pressure management required in running is different than hopping; quick movement requires automaticity & lightening fast coordination of multiple systems- something that’s delayed in the first stages of postpartum recovery. Pain with penetration is more than diameter; it can be protective muscle guarding, hormone imbalances causing tissue sensitivity, incomplete relaxation of the pelvic floor & possible issues related to a post-traumatic birth. This is just a quick sampling of all the things that run through my head when patients share their stories.

But HOW do I know?

  • I LISTEN.  You’ll get more than 11 seconds to share your story (AND NOT get interrupted..A 2018 study showed that patients have 11 seconds to explain the reasons for their visit before physicians interrupt).   
  • I ASK.  I make sure to listen to your WHOLE story & will probably ask for more of it (most of the time patients tell us the answers, but they don’t know it).
  • YOU ARE THE CENTER.  I want to know what YOU think is going on (most of the time you just need someone to connect the dots)
  • CONNECTIONS.  I look for patterns & threads that connect past issues & current ones.
  • REFLECTION & CHANGE.  I make a clear hypothesis & have a way to test it; changing direction if results aren’t as expected.

Fill in the blanks.  Connect the dots.  Develop a complete picture.  Together.
The system works.

But what about the coconuts?
The mystery has yet to be solved.  I admit, I haven’t poured all my energies into solving this one!  I’m missing a lot of information;  I’d need to start a database including dates & times we found them, what type of coconuts, & a high level sting operation involving night vision goggles & cameras….& yes, I’d have to listen to the coconut.  There must be an answer, a pattern, a solution!

While I’m still trying to balance work & virtual schooling, I’m going to stay in my lane & stick to pelvic floor work. If you have any thoughts as to why coconuts keep showing up on my neighborhood street, I”m all ears!

Stay safe & watch out for stray coconuts!

PS Having trouble sticking to your postpartum workout plan?  Check out yesterday’s IG #mythbustermonday post on being a Post Partum Exercise Dropout!

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