How Important is the Daily Dilating Log?

[Heather34]

Hi ladies. Immediately following my procedure, I found that reporting daily dilation to Dr. Pacik to be very valuable. It enabled me to provide an account of my work and progress, kept me accountable, and helped me to further own the process of overcoming vaginismus. I found that it significantly contributed to my overall success.

Dr. Pacik has written the following concerning the daily dilation log:

“When a patient returns home, they are asked to keep a daily log of their dilation schedules and to enter the most recent day at the top of the word document. The common theme is that patients start slowly, with the smaller dilators, and work up to being comfortable with the larger dilators. The important aspect is to take responsibility for one’s own dilation schedule. When our patients are diligent with their dilation and their log, the successes are amazing!”

Other forum members have further written:

Patient 1: “Prior to having the Botox treatment with Dr. Pacik, I was trying to dilate on my own at home. For a variety of reasons, I found every reason to avoid / postpone / procrastinate with the dilating (eg: not in the mood, too tired, does not seem effective, not sure if I’m doing it “right,” can’t get very far with these, “stuck” in the same spot, progress stunted or even reversed, feel like a “crazy woman” doing this, would rather be relaxing with my husband/can’t let him see me like this, embarrassed, etc). As you can tell by my laundry list of excuses, there was lots of uncertainty, awkwardness, and negative self-talk involved with dilation. Thankfully, Dr. Pacik’s 1-2-3 punch reversed all of this. Now that I’m under a doctor’s care -with VERY SPECIFIC directions of how, when, and how much to dilate – the excuses have seemed to melt away. Plus, my body is cooperating AND my husband is completely “in” on the expectations and the process. Not only has he seen me with a dilator in me, but he even knows how to insert one in me. But, … perhaps the most significant aspect of Dr. Pacik’s “prescription”: the daily reports! Because I know that I need to TELL my doctor IF/HOW I’ve actually “done my homework” — I’m more likely to get the job done.”

Patient 2: I think that the daily dilation schedule definitely is key! It truly makes you accountable for your actions (or lack there of sometimes). I know that for me personally it has been a tremendous help in order to keep me on track. Also, it is good to go back and see your own progress. From day to day and week to week things sometimes all start seeming the same but it is very beneficial to be able to go back and actually see where I’ve taken shorter periods of time to insert the dilators or been able to leave them in longer, etc. We can do it ladies! We’ve invested time (and money) into the procedure….we have to be sure that we also follow the after-care plan!

How important is the daily dilating log? What have been your own experiences with it? Do you feel as though it has kept you accountable and added to your success? What would you advise for future patients who may be reading this right now?

[Nakitalab]

I found that the log was extremely helpful to me in a couple of ways. It helped me be consistent and accountable. Knowing that I needed to send out my log each night, helped me to dilate on those days when I just didn’t want to because I was too tired or didn’t want to take the time. Secondly, it has confirmed the progress that I have made since my procedure. In the beginning months there were days when dilating might not have been so easy and the log was like a quiet cheerleader for me because I could go back and look at previous dilating sessions and see that….yes I was able to dilate with blue…today it might not be going in as easy….but I was successful in the past. I would totally recommend that new and future patients use Dr. Pacik’s dilating program and the daily log. To me, this is a big/crucial step towards being completely free of Vaginismus.

[LoveConquersAll]

I was wondering if dilating daily is something that you’ll have to continue to do forever?

[Dr. Pacik]

Most often patients dilate about two hours a day for about six weeks and sleep with the medium dilator every second to third night which helps set the stage for the morning dilation helping to passively stretch the vaginal muscles while sleeping.
Later many of my patient’s do well just dilating for 15-30 minutes a day.
Some patients regress when they stop dilating at about six months and for this reason I recommend some dilation during the week for a year.
More information can be found in my book “When Sex Seems Impossible…”, on the website by doing a search for dilators and by linking to
http://www.vaginismusmd.com/vaginismus/dilation/

[Becca]

I know I am only a few days in, but I already am loving keeping this dilation log. I, too, tried to make myself dilate before (as I could sometimes get a couple of the little ones in – with a lot of pain and discomfort) but I never wanted to do it because it was such an awful experience and made me feel badly about myself. I am 5 days post procedure and it has been encouraging to see my progress in my log already. I struggled at first and had trouble even getting the #4 in the first couple days, but then this morning I was able to transition to the #5! So being able to see it on paper is great for keeping me accountable, and being able to see that YES change is happening!

I will say that I have been sleeping with mine in quite often so far, that’s okay too, right? I am just so eager to progress and be able to have sex with my husband and I just feel super motivated right now. Sleeping with them in is not the most comfortable thing, but its not very painful, just kind of awkward and uncomfortable, but it gets the job done. This morning when I woke up and was taking the #3 out that I slept with, I could SEE my vagina was more open than it was last night, I could see that it was more stretched and the #4 went in super easy, and then an hour later I was able to get the #5 in. 🙂

[Heather34]

Hi Becca. This is a wonderful post and you are making tremendous progress!!!! Post-procedure, it truly is eye-opening to see the changes that take place down there. I went from never being able to insert even a q-tip prior to then being able to insert the various sized pure romance dilators, and, I too, witnessed the change that you describe. The more time that I spent dilating (i.e. sleeping with the dilators, etc.), the more I physically stretched and noticed this as I had an easier time inserting the next sized dilator. This physical accomplishment also built my confidence up greatly and significantly reduced my anxiety in the process. It is wonderful to be able to use the daily dilation log to see your accomplishments and to also get help and support from Dr. Pacik and Ellen along the way. :):):)

[Becca]

I agree, Heather! I feel like the accomplishments have also significantly reduced my anxiety. I have to work now on allowing my husband to control the dilators sometimes. That is really hard for me. Although, he has been awesome at helping me make sure I have it going in at the right angles and all of that – he loved being able to be a part of the procedure with Dr. Pacik and has really taken in all that Dr. P showed him during the procedure. 🙂

[Dr. Pacik]

Though recommendations are made for dilating during the first month post procedure, after this there is a wide divergence as women get to know what they need to do. They have a greater sense of how their vagina is responding to the dilation. Sometimes only 15 minutes a day is fine and there is no further pain with intercourse, some women sleep every night with #4 or the #5 dilator and do minimal dilation during the day, others maintain their full schedule for a year. This is all detailed in my book “When Sex Seems Impossible…” Ch. 11 p,87

I tell all my patients to keep their dilators which can be of great help during menopause. With the reduction of estrogen and the onset of dryness, intercourse may be painful once again at this stage and periodic dilation has been helpful to make intercourse more comfortable.