Guest guest Posted September 19, 2007 Report Share Posted September 19, 2007 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 " . Quote Link to comment Share on other sites More sharing options...
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