Hey there, friends. Miss me?
If you have been keeping up with me, then you know that Wednesday was my first appointment with my new “physical therapist”. Or so I thought. If I have learned anything from reading other women’s blogs and stories, it is that dyspareunia is not a short battle. It takes time to figure out the issue, and then even more time to find something that helps.
When I started this blog, I thought I was almost done. In my The Long Road Here post, I recapped my months of doctors and my various wrong diagnoses. They doctors came to a somewhat definitive vestibulitis diagnosis, and I was scheduled for I surgery I thought would fix everything. The surgery was quick and painless, and the recovery was long and hellish, but I can confidently say that it worked. After meeting this new doctor, I am not really sure what is going on anymore…
Let me explain.
This new doctor, or team of doctors, is in a “post operative pelvic health” division of a hospital. A full-on hospital. The waiting room puts me with people who have been through traumatic injuries — most were in motorized chairs — and I’m just sitting here like “woe is me, my tiny vagina hurts sometimes.”
As if that wasn’t bad enough, this small group of ladies include a full on MD and 4 physical therapists that work together on their female AND MALE patients. The one thing I thought I knew for sure about pelvic walls and female health was that it was a female thing. Well, it is not. The whole bladder thing — yeah, men can get that too.
Anyway, after I get into my little exam room, I know it is going to be bad. This doesn’t look anything like the nice, comfortable, tiny vagina gym that I was used to at my former PT clinic. No, no, no. This was full on sterile, you’re gonna get voluntarily raped by a few more instruments before this is over, room. The doctor comes in and is all awkward, can’t hold eye contact, and has a new helper that is older than her and wants to learn more about tiny broken vaginas, because, you know, they’re just so much fun. She goes through all my history with me, then seems shocked at the care I was given. Shocked. She couldn’t believe I hadn’t had any formal testing, like an MRI, and to top it all off, implied that vestibulitis isn’t a thing, and that I had a fancy word for an overgrowth of nerve endings that develop into a painful nodule. I don’t really see the difference. But either way I had that little bitch burned off, and I could not be happier about that.
After going through my history it was time for her to jump into the physical exam, which when making this appointment, I didn’t expect. Does that seem odd? I know PT needs to know your problem to treat it, but I thought the whole “I went through surgery” thing made that kind of clear. Either way, the exam was thorough. She checked my spine, my balance, and my hips. Boy, did she check my hips. I knew there was something wrong with them since she kept talking to her shadow doctor instead of me. Then she poked my legs and butt with various things, gave me the revered q-tip test, and then the fun really started.
To give her credit, when I started crying she got a lot friendlier, and she never once suggested stirrups. She had to insert a finger to feel my muscles, but said if she couldn’t, they would just stop. I felt very confident I could do the finger. Shaking with fear or not, I will do almost anything to get better. I took the over-lubed doctor finger like pro. She pressed against the muscles bottom of my pelvic wall, or the ones toward my bottom. They were dull and pain free. She pushed to my right and they felt similar, but more achy when she made me push my knee inward. When she went to my left, I actually yelped. I didn’t want to move my knee in, but she made me and it sucked. It felt like the stabbing, shooting pains I had during my first, incredibly failed attempt at intercourse. The only thing missing was the excruciatingly sharp steak-knife sensation of my vestibulitis, so there’s that.
After all that fun, I got redressed and gave myself a good 5 minute pity party. When the doctor and her friend came back in she dropped some bombs. Basically, most everything I was doing in PT before either wasn’t helping, or was making things much worse. She said when I squeezed into a kegel, I don’t release. Though I can push the muscles down and make them relax a little, it takes me a considerable amount of time and consideration. She said doing my kegels or the squeeze and release exercises were harming my progress and I should stop them immediately. Bomb number one.
She then said that, although I may (or may not) have had the vesitbulitis-like issues, my muscle problems started long before then. She said her most common clients were dancers — mainly ballerinas. The posture we are supposed to maintain, mixed with the hyper-flexibility training of our hips all makes for an unhealthy pelvic wall. She told me that not being able to use tampons when I was younger was good evidence of this. Bomb number two.
Next she said that the second most common patient she had were people with anxiety. The whole vicious circle comes into play — women have painful sexual experiences and begin to associate pain with sex, which makes them anxious before having sex, making them tense up, which causes sex to be painful, which confirms the fears and can therefore cause pain. For me it is hard to say whether my pain caused my anxiety, or my anxiety cause my pain, but either way m anxiety will to nothing to help. I was diagnosed with GAD at 15, around the time that my IBS became apparent, another great vicious cycle in my life, but I have never done well with medications. The side effects for me always outweigh the benefits, and I would always prefer to find a permanent solution rather than a band-aid. She told me most of her patients see considerably slower progress without anxiety help or medication, and that I should seriously consider it if I wanted to make progress in a timely manner. Bomb number three.
Then we made it to my treatment plan. 6 to 8 months. The bomb to end all bombs.
I started this “journey” of mine officially 16 months ago. I called it a journey because I knew it would take some time for me to find a fix. 16 months feels like 5 years. My first goal was to be able to have sex on my wedding night. We had 10 months to figure it out, and it was embarrassing for me to have to tell everyone we were going to delay the wedding and have them think we were having relationship problems. As if tiny vagina problems were so much better? Then I found out 2 weeks before the wedding that I would not, in fact be having sex on my wedding night. Surgery came and went a few months after that and, another 6 month estimation. That would have put me at 3 months before my wedding. Enough time to get used to it before a great redo-honeymoon, or so I thought. Then I had to go and be an independent woman and move states for a great job and great new life with my perfect new husband. And I find myself sitting in another doctors office getting another 6 month estimation.
So what have I learned? Goals are meaningless? That the only thing that matters is what you do today? That tomorrow always has the opportunity to let you down?
I know that I will get better, because I won’t stop trying. I am calling myself “Optimistically Defeated”, because I am giving up without giving up. I know I will get better, but I know it won’t be anytime soon. I know one day I will be able to start a family, but not necessarily when I want to. I know that I will have to keep smiling while my friends talk about their sexual exploits, and laugh off pregnancy comments since they are universally considered acceptable to say to a married woman. I know that I will have to continue going home and crying on my husband’s shoulder when someone unknowingly rips my heart out when they unknowingly say “I’m next” at the office baby shower.
I can do it. I can deal. I’ve been doing it for a while now. Just a bit longer.
I have 6 weeks until my weekly appointments start. I go every Monday morning at 7 AM for 8 weeks, then meet with the MD to reassess. Until then I am just treading water.
But I think that is what I have been doing this whole time. All eight years.
I’ll be okay.