Dr. Pacik

This is a very important post for a number of reasons: As you are approaching five months post procedure the Botox is becoming less active. I am asked the question all the time “What happens when the Botox wears off?” The answer: Nothing. As long as you keep dilating the loss of Botox activity is a non-event. The question is also of importance so that others can understand that sometimes success takes longer. That is certainly not an indication of failure but rather high anxiety that needs continued support from you. It is important to constantly be in touch with the small victories: ability to dilate, ability to progress to the large dilators, ability to sleep with dilators, ability to have a GYN examination, ability to have you insert the dilators. These are all progressively larger victories when none of this was possible before the treatment.
I am amazed by the progress that “coffee” has made. How many of us would be able to overcome rape at the age of 22 with genital trauma? How about a strict religious and sexual upbringing, combined with significant fear of first time sex? How about the many past treatment failures that she endured, including long term treatment doing Kegel exercises, attempted but failed use of dilators, 13 years of psychotherapy, two years of physical therapy, one year of sex counseling, trials of topical anesthetics, muscle relaxants, anti-anxiety meds, anti-depressants and to boot a failed attempt at hymenectomy in 2006. All of this resulted in lowered self esteem and lowered libido (of course!). There was so much anxiety at the time of treatment I was unable to assess the higher muscles without the need for an anesthetic. The entry muscle was like a tightly closed fist not permitting entry of my finger.
In my book both of you are heroes and champions. You with your unfailing support and coffee with the amazing progress she has made. Overcoming twelve years of severe vaginismus is no easy task, and though the recovery seems to be taking “forever” it is a relatively short period of time given all the circumstances. The key is holding your course and not giving up. In celebrating each small victory as they come along and giving yourselves the time that is needed for healing. The progress that “coffee” made is sure to empower many others who also struggle getting over this condition.