conway emg

[hope4eva]

hey im about to have an emg with conway on wens ,when i spoke to him on phone he dosent seem to think i have pudendal nerve damage because my pain is not worse with sitting however he wishes to test me any how i am considering cancelling as my insurance will only allow me to see him once and im dealing with chronic yeast infections that wont go away with treatment ! i read this test can be painful and am rethinking if i should put myself thru this and drive 3 hrs ,my doctors believe have ic and my vulva pain is due to yeast infections and or vulvadynia my symptoms started after an uncomplicated vaginal birth one year ago if anyone has advice on what i should do i appreciate all ur thoughts oh also have to go to have urodynamics testing on bladder same wk as emg this is going to be a problem at work as i will have to call out and i am close to getting canned for call outs due to pain i cant afford to lose my job if conway thinks i probaly dont have pudendal damage he said if i dont have increased pain sitting theirs a good chance i dont have it but since rare things happen he wants to make sure im very confused on what to do thanks everyone !

[Violet M]

Hi Eva,

This is a tough decision. So as I understand it, your pain started after a vaginal delivery, right? The fact that this started after a delivery suggests there might have been an injury to the pudendal nerve. But you also say you have yeast infections. So, are they basing this diagnosis of yeast infections on your symptoms or are they actually doing a culture swab/lab test? If your diagnosis of yeast infection is based on symptoms of itching and burning then you may in fact have pudendal neuralgia and not a yeast infection because the symptoms can be similar. If you have a white cheesy discharge and confirmed lab test of yeast infection then obviously their diagnosis of yeast infection is correct but doesn't necessarily mean you don't have PN also.

Have you checked the website list of PT's yet? If there is one close to you then you might want to postpone your Dr. Conway appointment and have an evaluation by a PT trained to treat pudendal neuralgia first. I was diagnosed by a PT originally when the docs had no clue. If the PT thinks there's a good chance you have PN -- then you could go ahead and see Dr. Conway. If there are no PT's near you and you haven't had a lab test that confirms yeast, you may want to request they confirm the yeast infection via lab test before going to Conway.

These are just some ideas of how to proceed since you are concerned about your insurance coverage for visits to Dr. Conway and missing out on work. Hope it all works out well for you.

Violet

[nyt]

I ditto Violet's suggestions. Good luck.

[hope4eva]

yes its a tough call my infections have all been cultured and i believe this all started after being on antibiotics for uti symptoms unnecessarily for most of the winter i now will never take meds without a culture ,it seems this time the infection isnt going away or responding to meds and its very painful the doc says its not a resistant strain on culture and said to stop the antifungals so this is very confusing i have a very deep pelvic pain and will probably be diagnosed with ic after a urodynamics tset on 29th i am also awaiting ,i have done physical therapy with no luck in reducing pain but unfortunately my pt new nothing about pudendal damage and was awful in general she would cancel my apts the same day after id already found a baby sitter ! and only did external work but cuz my insurance ran out on pt i cant see anyone else unless its for a different condition possibly with another diagnosis i could anyhow conway basically said on phone that because my labor was very short 4 hrs and 15 mins of pushing and i dont have more pain with sitting theres a good chance i dont have pudendal damage but he does want to make sure im considering cancelling because i dont wish to do a emg if unnecessary plus i have to call out cuz noone would cover my shift im lost on what to do and i read something about how painful emg is on pelvic floor i definitely dont want to do this if i dont have to ! also before my recurring yeast issue my genital pain started to randomly go away after months of sharp nife like and burning with no infections i had a few wks of relief with vulva pain but not with bladder pain and abdominal then the infections started and i cant shake them i tried everything probiotics ,natural yeast products ext thanks to all who read and reply i appreciate your thoughts !

[Violet M]

Eva, if you had symptoms before the infections, then even though the cultures for infections were positive I guess you have to at least suspect a possible nerve involvement and that maybe you have more than one things going on. It does get complicated sometimes. I think your idea of getting a different diagnosis code so you can try PT with someone specialized in pudendal neuralgia is a good idea. And yes, the EMG is a bit painful but compared to PN it's over with quickly.