Saturday, March 2, 2013

The Nerve Block

My nerve block is scheduled for this Wednesday, March 6.  I didn't expect it to be so soon!  It's only a little over a week since I saw Dr. Howard.

This is the first time in my six years with vulvodynia -- pudendal neuralgia, I should say -- that I've felt medically illiterate.  Here's what I think will happen.

Dr. Westesson will do the procedure.  He will use a CT scan to identify the Alcock's canal -- and I think something else too? -- where he will first inject a numbing agent as a test to see if my pain is coming from there.  If he is certain that the injection site is the source of my pain, he will then inject a steroid.

The steroid is the actual "nerve block."  It's supposed to reduce the swelling in the surrounding area.  That swelling is, theoretically, what's causing the nerve entrapment.

The numbing agent is like Novocaine.  I will have a numb pelvis for a while after the procedure.  The steroid will take several days to work, and my pain may get worse during that time.  But after a week or two, if all of this postulating is correct, the steroid will kick in and my pain will go down.

My pain might go down!

For the past few days I've been really nervous about the nerve block.  I haven't been thinking about it specifically -- I'm just more anxious in general.  But today I am a teeny bit excited to see what happens.  It's an experiment after all.  I love experiments.

If the experiment fails, the docs will do a nerve block on my genitofemoral nerve, which is in the abdomen.  At least I think that's what they will do.  It is Dr. Howard's second theory about where my pain is coming from.  I think it might be involved given the pain in my bladder and clit.  But the pudendal nerve can be involved in that area too.

And then if that doesn't work...  I'll just be back here trying to figure things out.  But now I have Dr. Howard to work with, and he is an expert-expert expert on pelvic pain.  I haven't ever had a doctor to work with.  They've all been specialists insulated from each other, unable even to refer me to another department.  So, I am finally in the proper hands, and I am trying to trust them.


  1. Dear Esther,
    I just want to wish you luck. Be hopeful, how incredible to be finally diagnosed and have a treatment lined up. But please, speaking from my experience, don't be upset if you have pain afterwards. My flare, post block lasts upto 5 weeks and then there is a magnificant difference. Have you read my post on my nerve block:

    Will you be under general anaesthetic? I have always been and Dr Courtney lifts me in and out of it as he stimulates the different areas to make sure he hits the right spot. Incredible, but very effective. most important to find that trigger.

    Good luck, can't wait to hear how you go.

    1. Thank you Soula! That is a great post of yours. Thanks for the warning about the lingering pain. We'll see what happens, if I get to that "magnificent difference" :)

      As far as I know, I won't be under anesthetic. I think they will just use a local numbing agent. Anesthetic sounds like an interesting thing, in and out of it -- sounds like you have a skilled doc.

      Much love to you!

    2. With PN the anaesthetic, I believe, is ESSENTIAL. It's not possible to sit still through the procedure when they're stimulating the 'spot' to find it. Why would we want additional memories of pain, we have enough!!!!. Could be my private insurance kicking in there too... I can't wait to hear from you. xxx

  2. Good luck! I will be thinking of you. I know how exciting, yet scary and uncertain a big procedure can be. I don't know what the data is like for various pelvic pain nerves, but if it's any inspiration, I had complete cure of my sciatic nerve with two steroid injections... that was 2 years ago.

    Sounds like maybe they had her in and out of a twilight sleep, rather than general anesthetic.

    1. Oh it was a general if you are referring to me. I was under 40 minutes... blissful sleep, blissful for PN... nothing gives me relief like the anaesthetic.
      So happy to hear you have complete relief. This is my hope also and I'm making progress where most say there's no hope. don't believe anyone CARRY ON!!!

  3. Thinking about you and hoping that this treatment will work. Fingers, toes, everything crossed.