Research

A colleague at work who forgets that I have pudendal neuralgia, not vulvodynia (still, at least she knows and cares, right) sent me a link to this article. Thought I'd share it in case some of you haven't seen it.

Guidelines for Management of Vulvodynia Issued

"Clinical care should follow the principles of general chronic pain management," the review authors write. "Treatment should be holistic and focus not only on the primary site of pain but on its subsequent impact on the patients' lifestyle and sexual functioning. The evaluation of different treatments is very difficult because published research on vulvodynia has many limitations with poor patient selection, limited follow-up data and a paucity of randomized clinical trials."
"These guidelines act as a starting point to aid doctors and other healthcare professionals in the diagnosis and management of vulvodynia, and to increase awareness and education on the condition," the review authors conclude. "The clinician should play a role in the assessment and diagnosis of vulvodynia and liaise with colleagues in difficult cases. Team work should be nurtured and developed."

Pudendal Neuralgia & the MAPS Pain Clinic

It's not vulvodynia. This is interesting, because what is often Dx'ed as VVD isn't - it's this pudendal neuralgia mess. At least, according to my new doc - he says what I have "encompasses VVD" but goes beyond it. Sometimes (though not often), thank god for Old White Guy doctors. Dr. Stanley Antolak, in Edina, MN, came out of retirement to treat pudendal pain. He did a series of horrific tests on me to determine exactly where the nerve damage is (and it is nerve damage), then began a series of steroidal injections (blocks), which helped a bit...for a while. If I have sex, it's totally blown. Looks like I'm headed for surgery, I think, but not the kind where the pudendal nerve is destroyed - Antolak will go in and literally yank it over to a new place, on the theory that it's entrapped somewhere, rather than just inflamed.

At some point, I'll try to blog the experience at the U of MN pain clinic...probably after I report the treating practitioner to her board.

In the meantime, Prozac wore off (well, it has been seven years) and in the search for a new solution, plus lots of pain meds (I've been off 'em all for months now...but yay! the pain is still horrid!) and directly injecting things into my nervous system, I've been pushed into Serotonin Syndrome...let me tell you, that's a fuckin' day at the Fair.

How is everyone else doing? Thanks for checking in, Lora. Haven't wanted to write. It's been a really difficult two years.