Health Organization for Pudendal Education

steviee,

I am impressed. You are displaying remarkable self-awareness. You should really not stress over the ganglion impar block. You'll recover. I had 6 nerve blocks, botox, and 2 failed PNE surgeries. I recovered eventually.

Just a bit of warning regarding the psychotropic medications you are prescribed. I truly started to recover using the mindbody method when I finally discontinued similar drugs (I was on Ambien and Oxycodone). From what I read, benzos (or closely related Ambien) prevent the re consolidation of emotional memories during the REM sleep phase. Opioids equally numb your emotions. Somatoform pain syndromes and unfelt emotions are closely interconnected and processed by the same area of the brain (the amygdala).

I realize that Sarno allowed his patients to take medication for pain relief. It has been my experience however that my recovery accelerated dramatically when I stopped taking those medications. Strangely enough, my pudendal pain comes back for 2-3 days if I take an Ambien sleeping pill.

Stephen, are you able to see a PT who can do an exam and find out if there are any structural or muscular reasons as to why your pain might not be settling down? I think at this point you may want to do non-invasive therapies and wait for the pain to calm down. One other thing that you might want to do is to have a lumbosacral and lumbosacral plexus MRI done to make sure there is nothing obvious that would have caused your pain, especially if you haven't had an MRI at all yet.

Violet

Hi Violet,
Thanks for the suggestions. I've thought about PT myself but they're hard to find around here, i've searched, and i'm a bit worried about making things worse, because i know through self examination that there are very sensitive spots in my rectal muscles. I must admit, that i HAVE noticed ever so slight reduction in symptoms in the last week or so. (I'm touching wood as i type this).
The pain never completely went away before the block, but it varied depending on things like bowel movements or any sexual activity.. But, thanks to a very good psychosexual counselor, i could live a reasonably fulfilling life, knowing my restrictions. I think its probably going to be just a matter of letting it settle down, (however painfully slow it is). If it settles down to how it was pre nerve block, that will do for me. As i said, i can live with that. Maybe if it doesn't settle back down, then i'll mention the MRI to the pain doctor in April at my follow up appointment.
Stephen.

OK, that's great news to hear you sounding a bit more positive.

Violet

Thanks Violet.
I think i may have hit on something that may be responsible for this delay in recovery. Thanks to info on this site and advice from posters, (got some good advice from "keepmoving" yesterday i think it was but he/she seems to have removed his/her post.)
Anyway, my theory is that i've got into the "Painkiller/constipation" vicious cycle. When it flared up badly after the block, i started taking more painkillers, co codamol 30s, which were making me more constipated, and thus everytime i went to the toilet, i was aggravating the nerve even more, and consequently taking more painkillers etc etc....
I was taking fybogel and a stool softener, but these weren't doing enough. So i put wholemeal bread into the mix and that seems to work better. So the theory, softer stools=less irritation=less painkillers=softer stools. Sounds too simple but i hope it works. And maybe helps someone else who is in the same situation and hasn't realized it, like i hadn't.
Stephen.

Hope this new approach works for you. There are more ideas for constipation at the following link:

http://www.pudendalhope.info/node/32

Violet

The facet joint nerve block is done to see if it is in fact the facet joint that is causing your pain. They are similar to other nerve blocks, just specific to the location .
As far as the myelogram goes, and the headache....as long as you keep your head no higher than the 20-30 degrees that they recommend ( one pillow high) for the 24 hours afterward, except for meals and bathroom trips, you should be fine. Remember to drink caffeinated beverages. They really do help for some reason to ease the chances of a post myelogram headache.
The blood work is done to ensure that there is no infection brewing in your body prior to the myelogram. It is for your safety. The last thing you want is to be brewing an infection and having a myelogram.

Violet M wrote:Other options would be compounded creams that have ketamine, gabapentin, or baclofen. You could also try valium suppositories or some people even insert oral valium pills because they are much cheaper.

Violet

I'm taking regular oral gabapentin and it's not doing much to relieve the pain (and i'm on 1500mg/day). Would a compound cream be more effective?

You don't really know what medication will work for you until you try it but, regarding gabapentin, my understanding is that to achieve pain relief you need to be taking at least 1800 mg a day. Sometimes a combination of meds is more effective than one by itself.

Violet

volans wrote:

Violet M wrote:Other options would be compounded creams that have ketamine, gabapentin, or baclofen. You could also try valium suppositories or some people even insert oral valium pills because they are much cheaper.

Violet

I'm taking regular oral gabapentin and it's not doing much to relieve the pain (and i'm on 1500mg/day). Would a compound cream be more effective?

Gabapentin cream 6% has been used by some with vulvodynia and a study showed pretty good results with this cream