Health Organization for Pudendal Education

So yes I have been reading up on some of the posts here on the blocks. From what I understand, they are more of a diagnostic tool then a long term pain treatment. But it seems that some people have been cured with it after just one block. I'm assuming that is the rarity becasue there have also been posts that have been speaking of horrible pain flare ups. It seemed that they were only short lived though. I also read a post where someone was made worse for the long haul. So I guess it is a gamble.
A question that I have is, say the block is positive. Then what? Do they change your treatment? I'm already on meds and strongly think it is the pudendal nerve and so does Dr. gordon. What does a positive block mean for you other than a definate diagnoses?

I really do not know much else about the block or how it is administered. I'll try to find some info on here about that too. I do not want to be made worse!!!!! My mind is already fragile as it is.

Hi Chex,
I don't know what Dr Gordon's protocol is with regard to blocks but if the first one does 'work' diagnostically, a second and then sometimes third one is suggested. Take a look at this http://www.perineology.com/files/ics-glasgow-pnpi.pdf by Dr Antolak, although other Dr's exact preferences and treatments may differ to this of course. Hope it works well for you.
Take care,
Helen

I read something quite exciting to me on this site! No dr. has given me an explaination as to why I had other wierd symptoms that occured right after my hyserectomy! I was surprized to read this! Ok. I read that a block could also relieve "central sensitization" (whatever that is) in sacral cord levels. This would include the buzzing I had in my feet. I still have constant burning in my small toes that is so bad it keeps me awake and nothing..Nothing must ever, ever touch my toes! My family dr. told me this was the siatic nerve and to put a hot pac on my lower back. This did not help. I had also after the surgery had pain in my calf so went in to emerge thnking maybe I had a blood clot. There was nothing but I still have that calf pain now 18 months after the surgery.

So is this "central sensitization in sacral cord levels" all caused from the pudendal nerve? This site said that a block could relieve these symptoms as well.

Chex, Dr. Possover has some publications on radiculopathies, pelvic surgery, and damage that can occur to the sacral plexus. You can go to pubmed http://www.ncbi.nlm.nih.gov/pubmed and type Marc Possover's name in the search bar. It can be difficult to tell the difference between peripheral pudendal neuropathy and sacral root damage. I don't know if you had any pelvic floor repairs during your hysterectomy but according to Dr. Possover there can be damage to the sacral nerve roots/sacral plexus during this type of surgery and many of the symptoms can be the same as pudendal neuralgia. Keep in mind that the sciatic and pudendal nerve both come off the sacral plexus and are not too far apart in some areas. http://en.wikipedia.org/wiki/Sacral_plexus

Violet

What a wealth of info! I do not understand it all at the moment but I will keep trying. And I will take this info with me to discuss at dr. appointments.

My appointment is almost here. I've been waiting so long (mid-January), I'm partly looking forward to it, and partly anxious. When I get anxious my PGAD spikes and it's hard to get myself calmed down.. I'll work on it today, and hopefully I'll be able to manage my anxiety on Monday.. My appointment isn't til mid-afternoon, but likely it'll be late afternoon by the time I get seen..

It's finally here.. Appointment day.. Why am I still awake at 2:30AM???

I'm excited for you doubledgedsword! I hope you update and let us know what he suggests for you.

In a nutshell, Dr G suggests another MRI.. I think this one might be the MRN? Likely it's going to be downtown at another of the hospitals..

He suggested upping my Cymbalta to 90mg for a trial period of one month, but since I've basically managed my pain on 60mg, we'll leave it as is, with the option to increase it in the future..

He said he wanted to do that electrode test 'down there'.. That one I'm not really looking forward to.. Sounds painful from what I gather on here..

He's referring me to another doc for 'Mindfulness' classes to help me manage my stress and anxiety..

If none of these things helps, he's mentioned a nerve block for the future..

It went better than I thought it would (no rectal exam), and I didn't feel rushed when I was there. Since I've had past sexual abuse, he was very considerate to ask me if he could examine me, he told me ahead of time what he'd be doing, and it was very nice to hear the words "It's not all in your head".. Sort of validates me somehow..

From what I understand, it could be another month before appointments for these tests are put into place..

I'd welcome feedback/comments, thanks.

I think you have been caught in the Dr Gordon medical safety net DES Good news, I doubt you could have expected anything more from one consultation. He seems to be tackling your pelvic problems from all angles. You have got to get some good answers from this as well as coping strategies from Mindfulness.
Suppose the only other avenue would be physio, was it suggested?
I have had a pain management consultation myself today and feel as if I may be 'back on board' with treatment. The Dr was very nice and wants to try some different medication and like you up my cymbalta (adding Carbamazepine) As she said the trade off is going to be sleepiness (initially only I hope) and a bit of mind fug. (UGH!)
She said that this combo will hopefully stop the nerve signals firing and calm them down. Think I have been there done that but will try again as have never taken the Carbamazepine before (have gabapentin and pregabalin)
She also is sending me for some physiotherapy, done it SO many times, but am happy to try again as I too want to be gathered in by the (NHS) safety net. I don't think she took the pelvic nerve pain ENTRAPMENT fully on board but she didn't seem against the idea and only mentioned my spine a couple of times
Hopefully we are both on the road to. . . . . I daren't say it!!!! just happy to have help.
Helen