Sunday, September 28, 2008

The Fight is Gone

About a month ago, I visited a specialist on vulvodynia at the recommendation of my gynie. Leading up to the appointment, I was anything but eager. I had sunk to a new low mentally regarding vulvodynia and was wondering if despair was a stage of acceptance. I also had absolutely no interest in being poked and prodded and invaded -- the eight or nine months I had spent searching for a diagnosis still hung over me, and I felt like, specialist or not, this doc would be more of the same.

In the end, he was, mostly. The examination was fleeting -- no speculum, thank god; just a brief cotton-swab test to detect where I was most sensitive. As the Wikipedia article explains, the touch of a cotton swab can feel like the scraping of a knife when you have vulvodynia -- and it did. The doc said my vulvodynia was localized enough that I would be a surgery candidate if it came to that -- cut out the part that hurts and pull the vagina down to take its place. Lovely, I know. When I mentioned that my clit hurts sometimes too, he said surgery may solve the sex (intercourse) problem but not everything.

The doc didn't provide me with much information that I hadn't already gathered from the endless hours I've spent reading about vulvodynia online. He gave me a list of oral meds that might work to block the pain signals, but as I have bipolar disorder and the meds are anti-depressants and anti-convulsants, I have to clear them with my psychiatrist before I can try them. He mentioned that Botox injections have helped some patients, but that it's a new, unproven practice that insurance usually doesn't cover.

I asked him about hormone tests, but he said they weren't necessary for a young chick who's menstruating regularly. In the end, I walked away with a prescription for Lidocaine -- a numbing gel that he says has helped about two-thirds of his patients who use it regularly regain the ability to have intercourse -- and a feeling that while I hadn't been invaded, I was desperately without information once again.

I had leftover Lidocaine that my gynie prescribed me, so I tried it out for a few days in a row. Unfortunately, like everything except Vaseline, it just irritated my skin more, making it wrinkled and puckered. (Lovely...I know.) The script the specialist gave me is for a gentler form of Lidocaine, but I haven't filled it yet because...

I'm frankly in a state where I don't care to fight anymore. I used to believe that if I fought hard enough every way I could, somehow, someday, the pain would cease. I happened upon a diet change that significantly reduced my pain, a change I stuck to for over a year, but now, while I still respect it at its core, I don't follow the little tweaks I devised that helped me feel even better. I used to be open to medical treatments, but now I doubt so much that they can help that I don't even pursue them. I would rather ignore the possibility of improvement than embrace it because the pain has convinced me, in its years-long persistence, that it isn't going anywhere, perhaps ever.

But slowly I'm regaining my hope -- and my focus. I've mostly reverted to the good diet (which I will definitely share) after a month or so of self-abuse. I've still got the Lidocaine prescription in my bookbag, and someday it and a drug store and I will be in the same place at the same time and I'll fill it. In my heart, I fully believe that the pain is a permanent component of my being, but my head, refusing to judge my slouch, is asserting itself again and helping me help myself, guiding my hand when it's not too heavy or quick. It takes time. We break down once in a while. It's for good reason, and I think the best thing to do is ride it out until you have the strength to continue on.

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