Update on my PN specialist/nerve block trip

[Guest guest]

,

It is nice to

hear you are OK and that everything worked out for you. It must have been an

exhausting two days – but it is over and you can go forward now and get well.

You gave an

excellent description of a nerve block – I hope others who want to know how

this is done will refer back to your post for the description. I have had three

nerve blocks – one unilateral, and the other was bilateral. My nerve blocks did

not help me which is another reason why I was a candidate for surgery. Also Dr.

Quesada is a wonderful compassionate doctor and goes out of his way to provide

the best care. He is my pain management doctor – I have been going to him

monthly for the last eighteen months.

BUT I DO want

to correct your statement (“I know they haven't done many of

them and from what I read some people didn't get too great of results from it”.)This is absolutely not true. Dr.

Conway is doing on an average of five per week, and (I spoke with him on

Monday), every one of them has been a success. I personally am in touch with

six women who have had the surgery, and we all are doing great – on the road to

recovery, and it is going to take time for the inflamed nerve to calm down, but

we are all absolutely better. And without this surgery, there would have been

no hope for recovery, because the nerve was entrapped, and there was no other

way beside surgery for it to be released. So, I don’t know where you got your

information from, but Dr. Conway is doing a marvelous job in helping to heal

and fix this awful condition. And I certainly would recommend it (and Dr.

Conway), if other options did not work.

In your case,

I am glad you had the nerve blocks done, and you won’t have to consider

anything else.

nne

From: VulvarDisorders

[mailto:VulvarDisorders ] On Behalf Of emsuc02

Sent: Wednesday, September 19, 2007 5:20 PM

To: VulvarDisorders

Subject: [sPAM] Update on my PN specialist/nerve block trip

Ok, I'll warn you that this is very long but

there's a lot to tell and I've seen some people on

here asking about PN blocks so I figured I'd give you a run-down of what

happens…also

that I'm posting it in two groups so sorry if you get it twice.

Yesterday I got back from the pudendal specialists in New Hampshire (Conway and

Quesada). Overall it was an ok experience but started off pretty badly. Monday

I met with

Dr. Conway and had the pelvic exam and emg test. I was so scared of the emg

test that I

wasn't sure that I could go through with it, but in the end I decided if I

didn't I would

always wonder. Just the thought of having a shock to my clitoris, which is

where I have

pain, not to mention the pressure from the thing they used was just terrifying

me. But it

actually didn't really hurt. The nurse confused me though because she said my

nerves

were conducting " beautifully " but then when I left the room she

stopped me in the hall and

said that two of the tests had numbers in the 4's and 5's and they should be

below 2

which meant that I have an entrapment on both sides. This just ABSOLUTELY

scared me to

death and I went outside with my mom and was just bawling and wanted to leave.

It didn't

make sense to me how I could have an entrapment on both sides but only have

pain in the

clitoris and no where else in my pelvis. I was convinced that they would say I

need surgery

and I was very scared because I know they haven't done many of them and from

what I

read some people didn't get too great of results from it. But my mom convinced

me to go

back inside and meet with Dr. Conway. Thank god I did because he said that I'm

not a

candidate for surgery and they don't think I need it. He said from the pelvic

exam he

could not find any spots that would indicate an entrapment- all my answers to

his " does

this hurt " questions were " no " . He said that he thinks my

pudendal nerve is just irritated

from maybe a tiny tiny entrapment that wouldn't require surgery or just from

plain old

irritation. He said that he really thinks several nerve blocks will greatly

decrease my pain if

not completely and that his other patients with my symptoms have seen good

results from

the blocks. He was very nice and patient and took the time to explain the

pudendal nerve

to me and my mom and answered all the questions we had- and he was also funny

as

nne said which was nice. When I asked why my emg results were the way they

were

if he didn't think I had an entrapment or needed surgery he said he couldn't

really give me

an answer besides the thoughts of tiny or former entrapment or irritation or

maybe even

an entrapment further up that he couldn't reach which we would have a better

idea of after

we see if the blocks work. But in the end he really thought the blocks would

help.

So then the next day I saw Dr. Quesada for the blocks. (and of course to make

the whole 2

days even worse, we were late for my appointment because we were lost and my

mom got

in an accident- no one was hurt- but I had to get a ride to the hospital for my

appt. from

someone who lived on the street there and that meant my mom wouldn't get to

come in

with me to hear what he had to say) So I had to explain the whole thing to Dr.

Quesada-

mainly aching/soreness pain with direct touch/pressure to the clitoris, and

sometimes

when sitting, no other symptoms. He said the same thing that Conway said that

the

blocks should help and that we'd do them 2 times, bilateral both times. After

the 2nd

time we should have a better idea of if more blocks will help. He warned me

that I would

be numb for the rest of the day/night and then my pain would probably come back

for a

week or so and then hopefully the blocks will kick in and start decreasing my

pain. In

response to some of my questions he said there is always a risk of infection

but they've

never seen it happen and that the blocks wouldn't cause any permanent damage

because

it's not going right into the nerve. So then we did the blocks. Since they were

guided with

an x-ray I had to lay down on my stomach on the table and an x-ray machine was

above

me showing my bone structure in my pelvis. He gave me a shot of stuff to numb

the area

and then put the needle in and I had to tell him while he was gently moving it

around

(using the x-ray to get it as close to where the nerve runs along the bone)

when I felt pain

shooting up towards my rectum, vagina or clitoris because that meant he was

real close to

the nerve. That was the worst part feeling that shocking sharp pain go up to

those areas

and when he got it they marked it on the x-ray (so they'd know where abouts to

start next

time and to see how close to the bone it is) and injected the coritsone,

lidocaine, and

heparin. I've had those same shots several times in my foot before when I was

running so

that part wasn't too bad. And then they re-did it through the other butt cheek.

Something that was very interesting and very informative was what Dr. Conway

mentioned

and Dr. Quesada confirmed with the x-ray- the way my bone structure is in my

pelvis and

spinal area, there is one bone (I forget the name) that the pudendal nerve runs

very closely

to and that is often where the entrapment happens on people- on me that bone

runs

basically right up to the pudendal nerve and is more of a triangle whereas many

people

have almost a U shaped bone instead. He said that this leaves me more

susceptible to

pudendal nerve problems just because there is a greater chance of inflammation

from the

friction and whatnot. Especially since I used to do gymnastics, snowboard, did

squats

almost every other day for the past 4 years, then was on a bike every other day

doing

workouts because my foot was hurt for 4 months and I couldn't run and to top it

all off

now I have a desk job…this all could explain why my pudendal nerve seems to be

inflamed

and stuck in the pain loop. So I was numb for the rest of the day and even a

little this

morning and had some pain but not too bad. The worst part right now is that my

butt is

VERY sore from where the needle went through the muscle…it hurts to sit because

it feels

like my entire butt is badly bruised, but that should go away in a day or so.

So, in the end

it was an ok trip because both of them think that several blocks will help

reduce, if not get

rid of my pain, and they both also seemed like if the blocks don't help that

they'll work

with me to try to find out what will. I thought it was interesting that my

gyn/ " specialist "

back home didn't think I had Pudendal Neuralgia, but Dr. Conway (the PN

specialist) does

and I never would have been " referred " to him by my doc back home- I

had to do it myself

and do the research and tell him I was going and I was getting the blocks done

up there

and not by him (he wanted to do the local nerve blocks to the tissue around the

clitoris

(which I think is more like a trigger point release type thing, and also that

if it's a

pudendal problem those type of blocks won't help). I've tried all the other

things-

different meds and pt and nothing helped and that nerve is still irritated so

hopefully this

will work. I'm keeping my fingers crossed and praying that it works. I'm only

22 and have

had this pain for almost a year now- I've had enough and want to just go back

to being

" normal " .

[Guest guest]

When I talked to Dr Conway he made reference to seeing his pt, I assumed he had a pt llocal that worked with him?

CSee what's new at AOL.com and Make AOL Your Homepage.

[Guest guest]

oh ok I thought he had a pt on staffSee what's new at AOL.com and Make AOL Your Homepage.

[Guest guest]

I'm not really sure- we didn't really talk about PT's

expect that I probably don't need to see one.

nne said he consults with P. from CA- I

don't know if he refers people to anyone local- I know

that people do come from all over to see him so it is

probably too difficult to refer PN people to a PT

locally.

--- Carolyn52192@... wrote:

> When I talked to Dr Conway he made reference to

> seeing his pt, I assumed he

> had a pt llocal that worked with him?

>

> C

>

>

>

> ************************************** See what's

> new at http://www.aol.com

>

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[Guest guest]

,

I'm glad you are finally getting what sounds like some concrete

answers. It also sounds like this is going to work for you and should

help you in the future knowing what might happen and how to deal with

it. You go girl!

fs