Elements for Success

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    Hi ladies. There are so many different elements that made Dr. Pacik’s treatment program work for us when countless other avenues that we tried failed. In examining this, some crucial parts were having the procedure under anesthesia and waking up with the dilator in place and also having Dr. Pacik believe me when I said any form of penetration is impossible. An excellent blog actually describes all of these elements that worked for us:


    The Tightly Closed Fist and the Vaginismus Woman
    “If one can just imagine a tightly closed fist and then trying to insert a finger from your other hand into that closed fist – the finger cannot enter – it is just impossible – it seems like you are “hitting a wall”. This is exactly what it is like for women suffering from severe vaginismus when they are trying to dilate or having any type of penetration or intercourse.”

    My comments:
    Instead of saying as other doctors had said in the past “just relax and try to use dilators or consume copious amounts of alcohol”, Dr. Pacik recognized the very real physical block (i.e. spastic muscles) that prevented any insertion despite how hard I willed this to happen and wanted it to work. This was so important for both my husband and I.

    Dilation Under Anesthesia with the Botox Treatment
    “Our Botox Treatment Program for vaginismus is so unique because our patients are put under anesthesia for their Botox injections and for their post-injection dilation. By using vaginal Botox injections and inserting a dilator under anesthesia, patients obtain fast and dramatic improvement. Vaginismus sufferers who previously could not tolerate being touched are able to self-dilate to the largest dilator within three hours after their procedure. They continue to self-dilate the next day even after the long-acting anesthetic has worn off, and before the Botox has taken effect. Some may even allow their partner to assist in dilating!”

    My comments:
    I tried so hard to have an exam and wanted to but just couldn’t do it. When the doctor even touched the outside area of my vagina, my butt lifted off the table and I felt like I was going to die because of such intense fear/pain response. By being placed under anesthesia, I could finally take the first steps in overcoming vaginismus. I went from never being able to insert even a q-tip to being able to successfully insert, remove, and reinsert the largest blue pure romance dilator within hours of the procedure. My husband also assisted and we both were in shock as it was actually happening and I did not have my normal response of “no, no, no” or pulling away and retreating.

    Seeing and Feeling the Dilator an Aha Moment
    “Time and time again, we are able to witness many of our patients waking up from anesthesia and realizing that they have a dilator in place. They are all thrilled to realize that their anatomy is normal and that their body can accommodate a dilator! This is truly an aha moment — a defining moment where they gain real wisdom — wisdom that they can use to change their life! This gives me great joy.”

    My comments:
    This truly was an Aha moment for me and one I will never forget. I woke up with the dilator in place and immediately had to use the bathroom. I took it out, went to the bathroom, and then inserted right back inside in the standing position. I couldn’t believe it and was so, so, so happy. I am not sure if I ever would’ve been able to insert the dilators if I didn’t have this moment of waking up with the dilator already inside and knowing that I was not broken and something could be inside of me and also getting used to the feeling of it. I may have been able to but I believe it would’ve been more of a struggle and I needed this moment to progress forward.

    Success with Dilation Leads to Intercourse
    “It is always uplifting to witness a woman with Lamont Level 4 or Pacik Level 5 vaginismus to wake up from the anesthesia to realize that she has a dilator in place. One of our early patients later told me that waking up in the recovery room with the dilator “flipped a switch” in her brain. Unable to tolerate any form of penetration due to intense fear, she progressed from treatment to intercourse in 12 days and sent me the following email: “Day 12: My husband & I tried to have intercourse for the first time. It actually happened!!!!!! LOL. I felt relief and so grateful that I wasn’t the one person the Botox did not work on. I feel like I have a real marriage now. I feel triumphant! Thank you God and thank you Dr. Pacik!””

    My comments:
    The same thing happened for us – thank God and thank Dr. Pacik. We practiced with the dilators while in NH and then went home and faithfully dilated daily and then transitioned and both were, again, in awe that it happened and did not hurt at all. Going from where I was (i.e. no, no, no) to that point was one of the best feelings of both of our lives and we continue to be so, so, so grateful to Dr. Pacik and all of the staff in New Hampshire.

    What elements helped this program to work for you?


    I was one of those people that had very little success inserting anything pre-procedure. I was never able to insert a tampon. I could have a gyno exam but it was extremely uncomfortable and painful – and could only be done with the “toddler” speculum. I had a little success with dilators here and there but could never get the angle right. The most successful thing I did pre-procedure was years of physical therapy with my wonderful PT, Andrea. She was absolutely wonderful and patient, and very careful to explain what was happening to my body. She had a real understanding of this condition, and she and I were able to have very meaningful conversations about it – which I believe led me to have more confidence and success with PT prior to this procedure. Once I found Dr. Pacik’s website, I discussed the treatment option with Andrea. She was 100% supportive – didn’t flinch one bit when I brought it up – and said she believed I was a good candidate for the procedure. She was very direct saying that 2 years ago I wouldn’t have been a good candidate, but we had come so far in my PT sessions, that she believed I was ready for this next step. She couldn’t have been more right. I had my procedure done almost a year ago now (December 16, 2013), and I consider myself completely cured of this condition. After the procedure, everything was so easy for me – from inserting the dilators at the correct angle to my PT sessions with Andrea to inserting tampons. Easy, easy, easy! And looking back, if I’m thinking of true elements of success for this program, it’s three things:
    1) Having the guts to stand up – recognize the condition – and commit to the botox treatment (this is not easy – trust me – I know – I lived it)
    2) Learning the correct angle to insert the dilators once the botox shuts down those muscles (sounds like a small detail but oh so important for me!)
    3) Commit to dilating DAILY post-procedure. Every day. I remember something Dr. Pacik told me while in NH – 20 minutes is better than no minutes. So days when I knew I’d be busy – I’d slip one in while I was getting ready for work/blow drying my hair/etc. But dilating daily (2x) for at least three months post-procedure was absolutely key for me. Those muscles needed to be re-trained, the botox alone wasn’t going to cure anything, muscle memory needed to kick in and your brain needed to be re-trained too that it doesn’t hurt and insertion is possible. I cannot stress how absolutely critical this is. I mentioned it to Andrea one time – I looked at Dr. Pacik’s procedure as my “head start” to get ahead of this condition while the muscles were down. He delivered the “knock out punch” of those muscles for me, and now it was up to me to get them re-trained. The whole approach, with Dr. Pacik at my side the entire time via daily touch bases via email, is what truly equaled success for me. And if it worked for me – trust me – it can work for anyone.

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