May 23, 2008

Pain in the Ass: CT-Guided Pudendal Nerve Block

On Wednesday I had a CT-guided pudendal nerve block.  I hadn't anticipated it would be such an ordeal.  2 days before the appointment I received a call from the office saying that I had to come over an hour before the procedure, I couldn't eat or drink after 6:00 am that day.  I'm under a ridiculous amount of stress at work and unfortunately, I have my fair share at home as well.  I began to have some misgivings.

My mom was kind enough to go with me for the block.  I had to get completely undressed and wear gown.  I got an IV on the top of my left hand.  I was hungry, but cool as a cucumber.  One of the nurses even said, "I've never seen a woman this calm before this procedure!"  

I guess she jinxed me.  I finally got to meet the doctor who was performing the block.  He was very nice, but I think I got a little more information than I needed.  He told me that I needed to be awake enough to tell him if he punctured the nerve.  

That sent me into a bit of a panic.  I was all ready to be knocked out.  I thought all I had to do was lie there and look pretty.  I didn't want to be awake and in pain!  What if he did puncture the nerve!?!  What if this little procedure only made me worse?!?  

I started to feel hot and nauseous.  My mom got one of the nurses and I told her that I didn't want to do it, that I had changed my mind.  She was very surprised.  I was no longer her super cool patient.  I was a hot mess.  I was ready to rip the IV out of my hand myself.  

My mom suggested that I speak to the doctor and see if he could put my mind at ease.  I have to say, everyone on staff that day was just wonderful.  They were patient, understanding and kind.  The doctor and the nurse administering the anesthesia assured me that the risks were minimal and I would be well cared for.  

I decided to go for it.  I had to lie on my stomach with my arms stretched out in front of me.  My ass as in a tube for the CT.  Once they had everything lined up, I was given a local numbing injection in each butt cheek.  It hurt.  Then the big needle was placed on the left side.  "OW!"  Then another big needle was placed on the right side.  "OW!"  I'm not gonna lie.  It hurt.  Those needles were long!

After that second "ow" I was out.  I woke up feeling very happy and very relaxed some time later.  That was a wonderful sleep.  I felt so relieved about everything when I woke up.  Apparently, every time I said "ow" the nurse gave me another dose of twilight.  Good deal!  

I'm not nearly as numb as I have been with the previous nerve blocks.  Unfortunately, I have another raging yeast infection from a course of antibiotics.  And let me tell you, I can feel that!  I wish I couldn't.  

My butt is still very sore from the injections.  I feel like I got a tetanus shot in both cheeks.  

The steroid in the injection is not supposed to take effect for about a week, so I'll keep you posted on if I see some improvement.  I really need to nix this yeast infection first.  It's completely tainting my results and ruining my day!

I have a followup with my doctor some time in the next two weeks where we'll discuss surgery.   The CT-guided nerve block is supposed to be a good indicator of whether or not you should have surgery because it is so much more accurate.  The needle is in the potentially compressed canal.  

Hopefully, I'll have a clear indication of where to go from here.    

May 15, 2008

The Anatomy of a Pudendal Nerve Flare

I finally got the replacement part for my kneeling chair and not a moment too soon.  I'm in bad shape.  

Last Thursday night I got injured doing my favorite activity in the world.  It's amazing how the slightest shift in position can be the difference between pleasure and days of pain.  Essentially, my partner came down and scraped the front of my snooch a couple times.  Now everything around the opening of my urethra (sorry, I haven't found a better term for that) feels inflamed. 

The next day when I became aware of the extent of the injury, I found myself thinking, "Ha, what would a pudendal nerve decompression surgery do for this?  Nothing!"  

Oh, how short-sighted we can be...

The initial trauma sent pain signals through my pudendal nerve to my brain.  Those pain signals caused the nerve to flare.  It was only a minor scrape.  I have no doubt that it has healed by now.  The flare is drastically worse than the original injury.  At this point, the only source of relief is lying on my back.  I can't even stand without pain.  

I have my first CT-guided pudendal nerve block next Wednesday.  At this rate, I should definitely be able to test of efficacy of that procedure.

The results should also verify if the decompression surgery is right for me.     

May 8, 2008

Height Adjustable Workstation and New Questions

I gathered up my nerve and asked my boss if he would allow the purchase of a height adjustable workstation.  Although somewhat reluctant, he agreed because the price was reasonable.  

I am so relieved.  I didn't want to pay for it and I didn't want to fight for it.  And now it's here!

I've been using it for 2 days.  It's not the best.  It's wobbly and small, but it's better than a stack of boxes.  It will also be a better match for the kneeling chair, whenever I get the correct part.  

I've taken a number of professional risks by being up front about my condition.  But because I did, I'm getting the accommodations that I need.  I'm extremely fortunate to work for people who are understanding.  I don't think most offices would tolerate this issue.  

With the changes that I've made to my workspace, I've begun to think about delaying surgery.  Maybe if I can avoid the primary source of my pain, I can also avoid the need to go under the knife.  

I'm really not sure what to do.  I've been so hot to get sliced for so long, but now I'm starting to worry about potential complications.  

What if the surgery actually makes my condition worse?  

What would I do then?  

Surgery is the last resort.  

That's a really scary thought.      

May 7, 2008

Vulvodynia with a Side of Teeth

Before I had any proper diagnosis, before I ever heard the word, "vulvodynia," I said my vagina was ANGRY.  It became a separate entity from myself.  It was a hateful, torturous creature that caused me debilitating pain.  

I always felt like my vagina was a monster, hideous and cruel.  I was continually victimized by it's wrath.  My therapist, at the time, told me I talked about my vagina like it was a thing in other room and not a part of my own body.  

After months of anticipation, I saw a movie that embraces the monster that lurks between our thighs.  Teeth is the story of a girl who discovers that her vagina can serve as a weapon.  She has been blessed with a legendary vagina dentata, toothed vagina.  The protagonist is transformed from a woman ashamed of her body to one who is empowered.  

Teeth is an over-the-top horror/comedy that is not for the faint of heart.  There's a decent amount of gore.  I'm sure you can imagine who/what falls victim to her special fangs...