Physical Therapy Update for Vestibulodynia

So I started physical therapy in week 8 and it was really encouraging. I was about 70-80% better with the q-tip test and my PT said this is totally normal because it should take 3 months to full heal. After she palpated the area I recognized some internal pain that I had not really felt before because it was masked by the much more sensitive external area before surgery. I felt a burning sensation and some pain in response to pressure. She told me that this is what muscle pain in this area feels like. It manifests itself as tightness but also burning in some situations too.

I used the sensor to test my muscles ability to contract and relax and did fairly well (much better than when I first went last spring). I bought a small+ dilator to start and am going to work my way up to a larger one.  You start by putting lubricant on the dilator (I found surgilube worked really well because is doesn't burn at all) and insert it into the vagina past where it starts to hurt and so that you feel a slight stretching or burning and leave it in for 10 minutes (I suggest using a pillow and a towel to keep it in so you don't have to hold it.) Then just relax your muscles and read a magazine or watch tv while you sit there with it inside. I am trying to do this 3-4 times a week in between my PT appointments which are once or twice a week.

Physical Therapy for Vulvar Vestibulitis

I started physical therapy for my vulvar vestibulitis about a year ago. This was one of the first things my 3rd obgyn had recommended to me. I got a good recommendation from her about a PT that has worked with patients like me frequently. I had to buy a special sensor that goes into the vaginal opening and measures how well your pelvic muscles tighten and relax. You lay on a comfortable table (like at the doctors) and flex and relax your pelvic muscles on command (basically doing kegels). Your muscle movements are tracked on a computer monitor which you can view afterwards. Then my PT worked on massaging the pelvic muscles both interior and exterior. My muscles were clearly very tight from guarding. Because sex was so painful, those muscles would tighten even thinking about it. I also learned about several different stretches that help my muscles relax. I went 2x a week for about 6 weeks and showed great success in my measured results with the sensor. I learned how to control my pelvic floor muscles and most importantly how to relax them to reduce pain. The only downfall was that I saw no difference in the pain I experienced during intercourse. I stopped going at the beginning of last summer but I plan to go again in two more weeks when I should be 95% recovered from surgery.

Sitz Baths for Post Surgery...

Sooo... it only took me about a week of doing sitz baths 3 times a day to realize that they were really uncomfortable. The cheap plastic ones are so hard and I felt like the bottoms of my thighs were getting bruised! I decided to look for alternatives and so I ended up buying a Soft Sitz.

This is an inflatable sitz bath that is really inexpensive. So much more comfortable than a traditional sitz bath! Although just to warn you it doesn't have any holes in the back to let out overflowing water and it doesn't come with a plastic bag and tube. I still find that it works well though. 

If you are interested, I bought it on Amazon here. 

Vulvar Vestibulitis: Another Post Surgery Update

So... It's notw been around 3 weeks since my vulvar vestibulectomy surgery. I had my two week post op checkup and she said everything is looking good. She pulled at the skin 'down there' to get a better look at things which was a little painful but she said that was to be expected.

I also have still been experiencing back pain since surgery (although I think it's been getting steadily better). I called anesthesia at the hospital I went to and they said that most likely I have a bone bruise. This means that when they were putting the needle into my back for the spinal anesthesia, it must have hit the bone causing some bruising that should get better within 3 months... I was not happy about this at all. Granted it is just a little painful now, it is still quite inconvenient. I have my 2nd post op this friday and I will update again after that. Everything is back to normal for the most part. I am still doing sitz baths at least once a day and I feel the same now as I did before surgery (except for my back). I still haven't played any sports that require a lot of running or lounging as my Dr. told me to keep taking it easy in that respect.  I am looking forward to my appointment and please use the comments box below to ask me any questions...

Day 4 Update: an unexpected pain...

Today was day 4 since my vulvar vestibulectomy. Yesterday was probably the worst day so far... I got my period and the cramps were unbearable. I took 2 ibuprofen at 8am and 2 midol at noon. This was more pain killers than I have taken for the surgery. It was also 10 times more painful, easily. I just sat in bed all day for the most part and did 3 sitz baths throughout the day.

Today was much better. The cramps were pretty much gone I just got a headache from my hormones acting up. I felt totally normal today. I still haven't really looked at the area because I'm too scared I'll tear the stitches. I also went for a walk today; going slow and taking it easy. It was nice to get out of the house and I had absolutely no pain. I used a doughnut pillow for the car ride but walking feels almost 100% normal; sometimes I feel the stitches poking into me though.

More updates soon :) comments or questions welcome.

Day 2 After My Vulvar Vestibulectomy

Today is the day after my surgery and it's going well for the most part. I didn't take any pain meds until about an hour ago which wasn't for vaginal pain but rather from back pain. Originally I thought I had slept weird and that was causing some stiffness but then I realized the back ache is probably from the spinal anesthesia. I looked at my back and saw the 2 injection spots which were just dots with no apparent bruising. The back pain started this morning and has gotten worse all day. I took one ibuprofen around 5pm and that has helped some. I hope it feels better by tomorrow. I have done 2 sitz baths so far today: one this morning when I woke up at noon and one around 6pm. I didn't use the bag and tube this time - just the bowl that you sit in and I added warm water from a cup as it cooled off. I noticed some more blood spotting but not much and I have no pain or soreness in the area. I walked around the house today a little and just made sure to take it really easy. I had a bowel movement and tried my best not to push at all. The stool softener definitely helped. Now I'm back in bed just relaxing and doing some reading. Sitting down is awkward but is definitely doable with a doughnut pillow. Since it's not painful, I'm just doing my best not to stretch anything or put any pressure on the area. My legs are still a little shaky but I'm hoping that goes away after a few days too.

Surgery Specifics (Illustration Included)

Vulvar Vestibulectomy Surgery
 Click Here for Image Source Website 

This is similar to the surgery that I had performed. The main difference for me is that the stitches are done individually rather than with one long string so that if one gets caught or pulled the rest aren't compromised. I also have dissolving stitches which don't have to be removed. I also didn't have the skin removed as high up by the urethra as in this image. I did from about 2 O'clock to 10 O'clock rather than 1 O'Clock to 11 O'clock. 

Pre-op appointment - part 2

How long should the surgery take?
It's scheduled to take 1 hour and 15 mins but it should take less time than that.

How will I be sedated?
I can choose between a spinal where I can either be fully awake and numbed from the waste down or slightly drugged through an IV so I don't know what's going on while I'm numb from the waste down. My second option is to have a tube in my throat and be completely under anesthesia. My doctor recommended the spinal since I am young and healthy. I can decide the morning of the surgery when I speak to the anesthesiologist. The vestibule area will be numbed with a local anesthetic regardless.

How do I prepare for surgery?
I can't eat after 11:30pm the night before and I can only drink clear liquids until 4 hours before the surgery. I have to get to the hospital 2 hours before surgery is scheduled.

How long is recovery?
It should take a full 6 weeks before any stimulus should be applied to the area. At that point I will start going to the pelvic floor physical therapist weekly and gently massaging the area to stretch the skin.

What does the recovery process involve?
The first few days will be spent in bed or just walking around the house. After that I should take it easy for about a month with no strenuous exercise. Starting the evening I get home from surgery, I need to do a sitz bath 3x daily for up to a month. This involves soaking the affected area in luke warm water (with no soap) for about 30 minutes and then using a blow dryer with cool air to dry the area.

What is the risk of a recovery setback?
50% of patients break open the stitches which delays the healing process because the area now needs to close and heal on its own. This could push the recovery period back a few weeks. Straining when going to the bathroom or too much exercise can cause this as well.

Pre-op appointment today - part 1

Today was my Pre-operation appointment with my obgyn to discuss all the surgery details. The surgery is called a vulvar vestibulectomy and involved removing the painful skin tissue and a little bit of the area surrounding it. My doctor used a qtip to touch the sensitive area to determine what area needed to be removed. For me, it consists of the area 2pm to 8pm of the vestibule area. The vestibular glands will not be removed. Although my obgyn has only done 5-8 of this specific surgery (with all success) she is a very highly demanded surgeon at the hospital which I am going to. She says that she considers this a minor surgery with minimal risks but that all surgeries have some level of risk regardless. In my next post (hopefully tomorrow) I'll go into detail about the surgery protocol and the estimated recovery time.

Comments and questions welcome!

Why Me?

That is what I asked myself when I was finally diagnosed with Vulvar Vestibulitis about 3 years ago. I had been to 4 different doctors before getting a diagnosis and every since then, it has been an uphill battle (still far from being won). I found out something was wrong ‘down there’ when I had sex for the first time at age 17. The first time was painful, but it is for everyone, right? The only difference is for me, it didn’t get better; in fact it got worse as time went on once the psychological effects of associating sex with pain set in. Anyway, more about this later. For now I just want to give an introduction to my condition and share my story with other suffering from the same thing.

What I’ve Tried (in order for the most part):

- Amitriptolene
- Topical Lidocaine
- Premarin Estrogen cream
- Pelvic Floor Physical Therapy
- Topical Gabapentin
- Cotten sanitary pads
- Natural soap and shampoos
- Estrogen/Projesterone cream
- Estrogen/Testosterone cream
- Sea Berry Buckthorn Oil
- Calendula cream
- Calcium Citrate supplement
- Chiropractic
- Accupuncture (Just started)
- Surgery (scheduled for the end of December!)

Hopefully I didn’t forget anything… Obviously I haven’t had much luck since I have surgery scheduled for the end of the month. Feel free to comment with any questions or suggestions. I would love your input! I will work backwards in this blog and tell my story from the beginning while keeping you updated on my current progress. If you have any specific topics you want me to write about let me know!