Tuesday, July 8, 2014

Pain management #3: Appointment with Dr. Abdelmalak

First, anxiety.  My psychiatrist is really good at his job.  Last week he started me on a new med that has taken my anxiety from persistent dissociation all the way down to occasional nervousness.  He also yelled at me for not taking the Valium twice a day as prescribed.  "Hey, you said 'as needed'!"  "LOOK AT YOU."  He leaned over his desk and pointed his fingers at me in the most passionate display I'd ever seen from him.  "YOU NEED THEM."  Okay, so I'm trying to remember to take the Valium twice a day.  Still, I am HERE in the world again thanks to that other med.  I wish I could explain what it's like not to be here.  It's terrifying.  It feels like some part of the universe violated the Prime Directive and gave me more info than I could take.

Every time I've stepped out of the house over the past few days, I've felt like a superhero.  Again, that's not something I really have words for.  But because of it, because it feels like my anxiety is holding steady at a low level, I decided that tomorrow, I will go back to the office.  I have confidence that I can do it.  It's time.

My lingering concern is that I will feel judgment from my coworkers.  I already feel it.  I know how they talk about other people, so I know how they talk about me.  Here's the important part: you can tell someone in my position that other people's judgment doesn't matter, that it's their business and not mine, that I know the truth about me, that they might not even be judging me.  All of that means nothing to me.  I am so vulnerable with the stuff I've gone through that any amount of judgment -- even imaginary -- leveled my way makes me feel like shit.  I've got so much weird stuff going on that I feel like the universe doesn't even want me.  So I suggest never trying to tell someone who is afraid of others' judgment that they have no reason to be afraid, especially if you're not in their shoes.

But today at my doctor's appointment, this guy stuck his fingers here and there, tested my nerve sensitivity up and down my arms, my back, my abdomen.  My left genitofemoral nerve -- radiated pressure-pain, made me feel like I was going to pee all over the table.  My right genitofemoral nerve -- not as bad.  Then inside.  6 o'clock on the vestibule/rectum.  The bladder.  The right pudendal nerve.  The left pudendal nerve.

He poked each spot for one second, but by the end I was crying.  Colors bled over my face.  Again, words fail me.  It's hard to write about even now because it was so scary.  So I won't.

I think it will take another post for me to go into all the details of the visit.  I learned a lot of stuff, and I have good info to share with you.  The doctor defined causes for my pain, and I have a treatment plan that is comprehensive.

But right now, I will just stick with the subject of vulnerability, self-doubt, self-esteem.  I've noticed here and there how my self-esteem has plummeted over the course of my vulvodynia.  Tiny little things that I wouldn't even expect.  But today, I noticed a huge gain.  When I have someone like Dr. Abdelmalak standing in front of me telling me that my pain is real, is severe, that the pudendal nerve is "the most important nerve in the body" because of how awful it can make your life when it malfunctions, that it sucks that I can't tell anyone about my pain because of where it's located, that it sucks because it's so hard to treat, when all this stuff is coming out of his mouth unprompted because he knows pelvic pain so well that he could probably write this blog and hit my perspective dead-on --------- when THAT happens, I feel legitimate.  And that's what I have to hold onto when I go back into the office to face my coworkers after working from home for several weeks.  No matter what they say about me, how they judge me, no matter what I fear might be wrong with me, that I am a slacker, that I am a pretender, that I am not strong enough --- none of those things is true.  This is real, and frankly, given the pain I felt today during my examination, I think I am doing fabulously.  It is a miracle that I am still able to work -- and a double miracle when I pair the pain with the anxiety.  I feel fortunate and strong.

I came home today intending to finish up the work I missed doing because of my long appointment, but I couldn't concentrate.  I showered to get all the lovely KY jelly out of my cooch.  I ate a bunch.  I browsed social media while I ate.  I logged on to work, but my brain kept timing out.  So I feel like a failure.  I feel like I failed my coworkers.  But I will pick up in the morning and get it all done just like I do every time.  And if I fear judgment, I will remember the pain I felt during my examination today, and I will respect it.

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