This time around visiting Dr. Westesson for a nerve block -- the fourth nerve block overall -- he decided to try a block about 1/3rd of the way down from the ischial-spine site towards the Alcock's canal. Again, the test for likelihood that entrapment is at a particular site is whether the anesthetic injected along with the steroid relieves the overall pain. The first block -- at the ischial spine -- relieved about 90% of the pain. The remaining pain seemed to come and go as my bladder filled and emptied, which may suggest interstitial cystitis.
The first block at the Alcock's canal missed the nerve -- I felt no numbing in the area at all after the block. The second one hit the nerve and numbed the area, but the anesthetic didn't take away the pain. That suggests that the entrapment is not at the Alcock's site.
This block, about 1/3rd the way down from the ischial spine, numbed the area and, like the first block, took away most of the pain. That's a good sign. The entrapment might be in that area after all.
I mentioned to Dr. W that a couple weeks after the first block, I peed 5-6 times in a row across 2 days with very little pain. The only other time I've had that kind of relief from pain during urination is when I've spent several consecutive days lying in bed. But the relief didn't last, perhaps because my period kicked in right then and returned me to the status quo.
OK, this blog post is already disorganized, and it will be further, and it will probably be long. But I've learned that the more information I provide, the more help I am to those who are going through this. I hope all this helps and isn't too confusing.
The second period I got over the course of these nerve blocks lasted 2+ weeks. I stopped counting. Dr. W confirmed at this past visit that steroid injections can affect menstrual cycles, and there can be other side effects such as jitteriness and some other things I don't recall. He says he used to tell everyone about the side effects, but he doesn't these days because hardly anyone experiences them. Anyway, if you get steroid injections and weird things happen to you, don't fret (like I do as a paranoid 33-year-old) that you are entering early menopause.
During that 2+ weeks of period, I missed my ex-boyfriend SO MUCH. It was unbearable. In hindsight I realize the hormones were taking over, but also, the pain was so much worse from that second Alcock's nerve block that I just wanted COMFORT. I just wanted someone to BE THERE to HOLD ME. I tell you, being single is so much harder for me these days than it used to be. I feel very alone.
The pain, thankfully, has backed off to normal levels. I can sit without the spider of "exquisite pain" descending on me within minutes, and my bladder doesn't feel like it's filling with fire ants. When Dr. W was doing the nerve block this time, I could feel the pain traveling up the nerve towards my vajayjay, but not like last time when it was a razor cutting its way.
And as soon as my period stopped, my thoughts about my ex-boyfriend vanished. It's so funny how hormones and other chemicals can make thoughts seem so real. So if that happens again, I'll know what's really going on.
OK and speaking of, I saw my psychiatrist yesterday, and he says I am at my "darkest." He says I lack "personhood." Then there is all this other stuff he said about how if you don't have things you do just for you, for enjoyment, if you don't engage with the world, you don't have a self.
I explained to him that I don't even want to enjoy anything because I'm so afraid it will be taken away from me, and he said of course -- you have a moment of happiness and the pain swoops in and takes it away. Is this true? Is this the cycle? And also, I say, the cycle of happiness inevitably overcome by depression or anxiety, I don't trust anything anymore. How do I get out of this trap?
It has taken me everything to do the smallest things lately. A family gathering last weekend, I started getting ready 2 hours ahead of time, rocking back and forth from "I can't go" to "I want to go" and crying, anxiety attack, why is it so hard? Today I did the same piece by piece putting myself together to take a walk, I made myself do it, I wanted to so badly but it was a fight every moment just to get through the door.
How many pills do octogenarians take per day on average? Because I think if we measure age by pills I am way up there. I am on 4 brain meds now, more than I have ever been. I tried cutting back but it all fell apart. I can't do it right now. I need them all. And that sicks me out. How did I manage everything for so long, and why can't I now? I'm trying to remember that I have to be on these meds now to keep moving forward...that if I stay on them I can get healthier, to a point where I can be on fewer.
I think one issue is that my job is so isolating. When I was serving I saw different people all day long, worked with people I established friendships with, and most importantly wasn't in a situation that allowed agoraphobia to overtake me. My job right now, I see the same people every day without any chance of contact with others, there's no opportunity to develop friendships with them (wrong age/sex), and I can get away with not doing anything but going to work and going home, with rushed swoops through the grocery store that always make me dizzy back by the dairy section, why is dairy so disorienting??
This is such a long blog post, I'm sorry... it is a diary entry, and I hope if you got this far it hasn't totally sucked to read. After I saw my psychiatrist yesterday, his friendship and kindness and belief in me propelled me to visit a little grocery store I adore and buy shade plants to plant in the shade of the oak tree I worship that overhangs my porch, and I am listening to music for the first time in months... it's all about patience, self-forgiveness, and acceptance of things that disgust me (medication) that are the best route to getting better.
P.S. Dr. W says exercise when you have pudendal neuralgia is specific to the patient. There is no rule. There's only common sense: if it hurts, don't do it.