Treatment Journal: Day by Day

[zenely]

Hello Everyone,

I just had the botox treatment this morning and so far so good. I have decided that I would like to do a day by day journal cataloging my adventure after Dr. Pacik’s treatment. I feel this could prove extremely helpful for anyone that is going through the treatment, for anyone looking into doing the treatment, and anyone that is just curious. Hopefully it will shed some light on what may be considered normal “issues” post treatment and put some others at ease that may not want to lend their voice.

Moderators: Please let me know if this kind of topic is okay or needs moved to a different section on the forums.

Also note: I work almost full time, go to school part time, and have other life responsibilities that may prevent me from having time to do a post every day, but I plan on keeping this thread updated on a regular basis.

I’ve already written an introduction and back story post and you can check out my introduction/back story here:
http://www.vaginismusmd.com/vaginismus-md-forum/?mingleforumaction=viewtopic&t=758

Let’s get started!

Days 0 – 1:

We’ll start this story with the day before (day 0).
I live in the Northwest and spent all day Sunday on a plane. Literally; my day started at 2am and we didn’t land here until 8pm. By ‘we’ I mean myself and my husband.

Once we got checked into our hotel, one of Dr. Pacik’s surgery techs came to visit and check me in for this morning. Ellen was amazing. She was super nice, friendly, reassuring, and overall helpful and knowledgeable. She answered all my last minute questions and put an anti-nausea patch behind my ear. I’m sometimes prone to car sickness, so she put a patch on me as a precaution. I’m not sure if it’s something standard that everyone gets or not. That night we relaxed and got use to the time-change. I wasn’t allowed any food or drink after midnight so after getting something to eat I just went straight to bed.

This brings us to today (day 1). I went to Dr. Pacik’s office at 7:30am. Met the staff and said hi to one of the other patients that was being treated directly after me (Hi Haley!). The anesthesiologist introduced himself and put an IV in my arm, reassuring me about all he would be doing that morning and what to expect. From there, Dr. Pacik did his initial examinations and then I was put under for the actual botox shots. I woke up in the recovery room, rested a bit while awake, then was able to finally eat something. I didn’t feel any pain directly after and the biggest dilator was in place. I honestly didn’t even feel it there right away.

After awhile we started the dilator progression. First the biggest one #6 is rotated ten times each side. Easy peasey. Then that one is removed and you progress down to #5. You practice moving that one in and out and leave it inside for awhile. Then you switch to #4, do some more in and outs and leave that one in. #4 is left in all day until the next day (tomorrow). The numbing agent they use in the lube and such eventually wears off and you can start to feel it inside and it feels uncomfortable. Especially sitting. Sitting normally is probably completely out of the question while it’s in. In between these exercises I met the third patient (Hi Elizabeth!).

Once we got through all those exercises Dr. Pacik came in and did some counseling and told us what we needed to do the rest of the day and what to expect for tomorrow. The counseling was helpful and very informative as to what to expect.

I should note, that after removing the dilator and switching them in and out, going to the bathroom ,etc, there was traces of blood. Maybe more than one would expect, but all completely normal and nothing terrible.

As for myself, once we were about to leave the office for the day, I started having a stinging/burning feeling down around the entrance. Also told that is normal. The botox can take up to 7 days to go into effect. I had heard that the glass dilators were more comfortable than the pure romance ones, so I also borrowed the #4 glass dilator to see if it would be worth the purchase tomorrow. Totally is.

Once we got back to our hotel room, I crashed (so much flying + waking up early = exhausted to begin with. Couple that with the procedure and you just want to sleep). After I woke up, I switched from the pure romance dilator to the glass one and it was infinitely more comfortable. I could sit down somewhat more normal than before and walking was easier as well. I feel less awkward with the glass one in. It’s still uncomfortable and there’s some positions I’m just not able to do without inflicting pain in the area.

We went out to dinner after that. Mr. Mac’s Mac and Cheese was recommended to everyone on the forums, and I’m adding to that recommendation. It was so good! The employees are awesome as well. Definitely worth a try. We came back home and I decided to start writing this.

Some other notes for the day.. I took some ibprofun while at the office and have taken two doses since then. I wouldn’t say because I was feeling pain, because I only seem to feel pain in certain positions or if I’m sitting/directly pushing on the dilator in me. I’m just taking Ellen’s advice of staying on top of it, so pain doesn’t set in and make things worse. I’ll probably lower the doses tomorrow if I’m still feeling the same. I’m also not high on the anxiety level. I’ve overcome so much over the past five years with this condition that I think I view it differently and have come to terms with having to go through it. Also, my husband was with me all day and he’s been a great help when I need it. I’m also aware that you’re not suppose to remove the dilator at all, but I have when going to the bathroom, so it’s easier and I’ve been able to reinsert it just fine afterwards. I figure having it out for a couple minutes wouldn’t be so detrimental. However, with it staying inside you, the lube gets absorbed in your skin and so when you remove it, pain will be felt since it’s pretty much sticking to your insides. Twisting it before pulling it out helps lessen this, but still be prepared for pain if you decide to take it out for whatever reason.

Overall, I think today was a success. Tomorrow is the counseling session with Dr. Pacik. I plan on buying the glass dilators as well. I’m currently laying in bed propped up watching TV with my husband and will probably attempt sleep shortly. I say attempt only because I’m not sure how my sleeping positions will work with something inside me. I will let you know how everything goes! And hopefully these posts will help others.

Goodnight!

[zenely]

Day 2/Day 1 Post Procedure.

Holy mackerel! I’m filled with so much excitement right now. Let us start from the morning.

I woke up after sleeping with the glass #4 dilator and felt perfectly fine. I took a shower with it in (wore panties so it wouldn’t just fall out and break on the tub). After getting ready for the day my husband and I headed to Dr. Pacik’s office for the day after counseling. Removal of the glass dilator was super easy. Walking and sitting with it in throughout the day was also tons more comfortable than it was yesterday.

During the counseling session, we had breaks to do some progressive dilation in the office to make sure we could handle it on our own and if we had any questions. The bleeding I had from yesterday was completely gone today. There was a little (literally two spots) of spotting when I first removed the #4 glass, but after that there was nothing. I managed to get the #5 glass dilator in without any issues. The #6 glass went in fine, but it was very uncomfortable and I took it out after only twenty minutes.

The counseling helped a lot and answered a ton of questions. Found out that a problem spot on the left side (something I’ve known is a trigger point for the stinging burning sensation) is still prone to that stinging/burning. This could very well be a vestibulitis point and finding out that was still present was a bit discouraging and worrisome.

We left the office without any dilator in place, and I gotta say the break from having something inside was great.

Later in the evening I started to do my evening dilation to write up the daily log for Dr. Pacik. It was a little something like this:

I started with glass #4 for 15 minutes, pain was a 1/10. I had no anxiety at all tonight during dilation.
Went to glass #5 for 15 minutes, pain was a 2.
Went to glass #6 for 15 minutes, pain was a 5. (size #6 is similar to the size of my husband)

After awhile of having #6 in, the pain disappeared. I’m guessing this was due to the lidocaine/surgilube I used. Because of that, I felt a little ambitious.. and me and my husband attempted actual penetration. He went in easily! All I felt was some soreness but that disappeared once he was all the way in. Took maybe 15 seconds. We stopped at just insertion and stayed that way for about five minutes. No pain on removal.

I am perfectly aware this could be because of the lidocaine, but I’ve used lidocaine in the past and it was still too painful for penetration. I contribute tonight to be a major success and it has given us so much hope that this treatment will finally cure me from the pain I’ve felt for years.

I’m currently typing this with glass #4 in, which I plan to sleep in. I should note that the stinging/burning on the left just came back about ten minutes ago when I started writing this. It’s not terrible, but it is noticeable. I’m hoping that will eventually go away at some point as well. Also, to note, I did not need to take any advil today.

Overall, today’s been a good day.

[zenely]

Day 3/Day 2 Post Procedure.

If day 3 is suppose to be the worst, I guess it’s not too terrible. Dilating this morning went perfectly fine. It was about the same as yesterday. Spent the day relaxing and took a drive along the coast. Tonight I did my dilating and it was a bit different. The glass #4 went in fine with some initial pain on the left spot. Glass #5 was about the same. Glass #6 hit a higher pain number, but if I didn’t move no pain was felt. The higher pain did cause a little bit of anxiety that I haven’t felt until this point. Being a bit overzealous and wanting to conquer this as best and fast as I can, my husband and I attempted penetration again. Honestly, it was a weird feeling. Something similar to feeling swollen on the top but having the bottom feel like a bruise being pressed on. Not sure why that might be. I have glass #4 in right now to sleep in and it’s pressing against that left spot making it feel rather uncomfortable. Really hope that will work itself out. Either way we’re still a lot farther along than we have been in the past five years. That does give us hope.

[Becca]

Thank you so much for sharing all of this!! My anxiety has been really high this week and I think it is just the unknown, not knowing what to expect, so this is very helpful to me! I am from the NW too! 😉 I had already had my eye on Mr. Macs Mac and Cheese! Glad to know it is good! 🙂 thanks again for doing this journal, I am really enjoying reading it!

[vgfears]

Hi, VERY much appreciate your updates. Although currently not
a candidate for the procedure, Dr. Pacik& staff have allowed me to post(& of course
read& learn). My PT says I have a thickening on one side that may be part of hymen. I’m in my 50’s& just learned what this problem is . Of course I don’t have
relations( sexual or otherwise). Anyhow, she says do deep
breathing& also imagine elevator. Wondering if that may be helpful to you?
Also even though u’ve already had the procedure I’ve heard baclofen may be helpful. Of course check w/ the dr.
My PT asked me to ask my dr about muxing lido, valium, baclofen down there. Problem is I can’t even get past the labia
but it may help you. Thanks again for the updates.

[Janet Pacik]

I would like to add a note to vgfears: As vgfear noted, please do not use any prescription medications intravaginally without consulting your physician. As noted on drugs.com: valium together with baclofen may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs.

[haley.rid]

It is so good to hear your updates! (Hi Ashley 🙂 It was so great to get to share this unique experience with you and your husband. You’re such a fun, loving, happy couple, and I’m so happy for your success! It was such a comfort to be able to share similar feelings, discomfort, and success. Things are going great here. Dilating has been easy, and even a fun process! It makes such a huge difference to have such a supporting husband which I’m sure you’re aware of. Can’t wait to keep reading your updates 🙂

[zenely]

Becca – Thank you for the feedback! I’m so happy this is helping you. I hope it helps others as well. I’d also recommend Brother’s Pizza while you’re there. SO GOOD.

Day 4/Day 3 Post Procedure.

My day has been very exhausting. I didn’t have time this morning to do any further dilation past sleeping with glass #4 and despite just wanting to pass out tonight, I managed at least 45 minutes of progressive dilation. Even though I wasn’t able to dilate this morning, the overall pain tonight was improved. Little to no pain with glass #4 and glass #5. I did feel non-painful muscle spasms with the #5 in. Same when I had the #6 in, which had a lower pain rating of 3 tonight. I only felt the discomfort from the left side with #6 in. When I put glass #4 back in to sleep with, there was no pain at all. It was a little painful on that left side trying to sit down to write this post, but leaning back to take the pressure off made it go away.

[zenely]

Quote:

Quote from haley.rid on January 24, 2014, 00:50
Things are going great here. Dilating has been easy, and even a fun process! It makes such a huge difference to have such a supporting husband which I’m sure you’re aware of. Can’t wait to keep reading your updates 🙂

Hi! That’s awesome that you’re having an easy time with it! Having someone to support you and go through this together does help a lot. We’re lucky to have such amazing husbands (: We’ve made such great progress in such a short amount of time, it’s surreal. Keep me updated!

[zenely]

Day 5/Day 4 Post Procedure.

This morning went really well. I had next to no pain with any of the dilating and I managed to get an hour and 45 minutes in. Tonight started out okay, but as I moved up I started to feel pain again. That made my anxiety flare up a little bit since there was hardly any pain earlier and now there was. Thinking I might have overdid it? Taking a break from sleeping with one. We’ll see how tomorrow goes.

[zenely]

Day 6/Day 5 Post Procedure.

Today went a lot better. Even though I didn’t sleep with a dilator in last night, dilating this morning was back to low pain numbers. I split the ‘2 hour’ recommendation between morning and evening this time. 50 minutes total this morning, and 50 minutes total tonight. #6 had the most pain with a pain score of 4. After awhile the pain went away and it was just uncomfortable. I don’t know if it’s because they’re glass, but they instantly want to slide out (even with panties on) so I’ve been having trouble finding ways to position myself where they stay in and don’t cause pain. My husband and I also decided to try intercourse again, thrusting included. It seemed mechanical and I still felt pain (I’d say a 3) and I kept having a stabbing sore pain on my left side where my ovary or kidney would be. Come to think of it I forgot to mention that in my daily log. Otherwise all went all.

If there’s any post procedure readers, do you have any recommendations for keeping the dilators from sliding out? Or special panties to buy that work wonders for this? I’d like to eventually not be completely immobile while dilating.

[Dr. Pacik]

Tight bicycle shorts work well to keep the dilator in place. It is best to buy inexpensive ones that have only a thin pad. Tight elastic panties also work well. I would look forward to what others say about this.
Because it is so early in your recovery all bets are off regarding pain/discomfort and referred pain elsewhere. Once again it would be of value to read what others say about this.

For only one week YOU ARE DOING GREAT!!

[zenely]

Thanks Dr. Pacik!

Day 7/Day 6 Post Procedure.

This morning’s dilation went well. I managed to fold and put away laundry while I dilated and the pain was minimal. There was only some discomfort when moving around into different positions. No dilation tonight, instead I’m sleeping with the #4 and will resume dilating tomorrow evening.

With my work and school schedule getting back on track, my weekdays are usually very busy and hectic. Since I seem to be at a plateau with pain and whatnot, I will be posting updates only once a week; sometime during the weekend.

[Heather34]

Hi zenely. Concerning what to wear while dilating with the glass dilators, some ideas include:

– tight boy shorts
– jeans
– maxi pads or surgical gauze underneath the dilator (rite aid)
– less expensive cycling shorts without too much padding
– snug fitting elastic panties
– spanx
– “spanx” type shorts from CVS for around $8 each. Also from wal-mart for about $12 each
– panties with a cloth menstrual pad and one or two pad inserts, like they sell at lunapads.com and gladrags.com
– regular bikini panties with a pair of boyshorts over the top for an added tight layer
– yoga pants

Hope this helps. :):):)

[zenely]

Thanks Heather. I have tried almost everything you listed but they don’t seem to work well; maybe because I have a tinier frame so even though they’re fitted they’re not really tight on my body. However, I found some Under Armour compression shorts that are absolutely perfect! Little pricey at $25 but it’s what works for me, so a good investment none the less.

Also, I know I completely skipped posting last weekend. The past couple of weeks have been very chaotic and the treatment has been very up and down.

Today marks Day 19 post procedure.

Let’s start with the week I stopped posting every day. The beginning of that week was about the same as it had been until Tuesday when I started my period. It was a really heavy flow and different than how my periods normally are and I also wasn’t too comfortable with the idea of dilating while bleeding so much, so I didn’t. For four days I did not dilate.. and the entire time I was concerned I was going to be setback in my dilation progress. So on the fifth day of my period when I finally decided I should dilate, I had mild anxiety, but you know what? That day of dilation was probably the most successful day to that date. Nothing was setback. In fact dilation was easier than it was before and I had no pain! So to anyone worried about not dilating during their period, at least for me, it’s perfectly fine if you don’t. It didn’t set me back at all and like I said, it was actually better after the mini break.

But that brings us to the sixth day of my period.. where my vestibuldynia came back with a vengeance. Sigh.

I should note that I honestly feel that the vaginismus issue is completely taken care of. The muscle tightness and muscle pain has been pretty much non-existent since I underwent Dr. Pacik’s treatment. The pain I have felt and the pain I continue to feel now is linked to the vestibuldynia I was originally diagnosed with. Frustrating.

That bring us to this past week, where I’ve been on a complete roller coaster. The vestibuldynia pain is mainly focused on the left side and it tends to radiate out from there. The beginning of this week was plagued with pain that if I moved wrong while dilating, skyrocketed to pain worse than the vaginismus pain was. That was a very devastating realization to go through. I knew the treatment wouldn’t fix that particular issue, but it seemed like it was under control only to come back so fierce.. Dr. Pacik is very understanding of this though and is working with me to figure out how to treat it. I went through every treatment possible previous to the botox treatment and none of it worked to get rid of the vaginismus or vestibuldynia, so it feels like I’m back at square one.

With that said, I have been using cortizone 10 and lidocaine prior to dilating the past few days and that seems to tame it pretty well. The only issue I have with this is I know it’s just masking the pain and not fixing the problem at hand; just like before, but I’m giving it another shot and I’ll see where it takes me this time. It’s not a treatment that can continue forever, since using the hydrocortisone longer than a week at a time can be harmful, to my understanding.

This brings us to last night where my frustrations were at an all time high and I just did not feel like dilating. I was, er, feeling frisky? And was just overcome with frustration about not being able to just have sex like a normal person. So, instead of dilating, I pre-treated with the cortizone10 and lidocaine for a good while beforehand and then just jumped my husband. At first I felt some pain because of muscle tightness, but after about 30 seconds that went away and he was able to penetrate just fine with no pain. There was absolutely no muscle pain during, though I did feel a pin-prick pain most of the time on the left side where the vestibuldynia is centered. It was not debilitating though. Even though I technically haven’t reached the “pain free sex” status, I think this is a huge accomplishment regardless.

And that is how the past two weeks have been. Is there anyone else on the forums that has/had vestibuldynia?