I only have a few stitches left and I can see that they are falling out. I saw my doctor last week for my one month post-op visit and that's when she said I could go ahead and start using the dilators. She said it was very important to use the dilators in the peri-operative period. (fyi- I had a "full" vestibulectomy).
Just a background note- I did not have pelvic floor/muscle issues beforehand-- I could use tampons and have sex (sex with horrible pain) and somehow I was able to keep my muscles relaxed. I will probably continue using the dilators at least once a week once I reach the maximum size just to keep my body used to the feeling (since I don't have a partner). My doctor said that there was no risk of vaginal stenosis (narrowing) if I quit using the dilators after I reached the maximum size. Once I do have a partner though, I think I will be afraid to have sex - I guess because that is the ultimate test of whether or not the surgery worked, right? My doctor said it would be okay for me to have intercourse now if there was someone "special" in my life, though there is not and I am not mentally ready to have intercourse.
I'm so glad to be on this "side" of the surgery (post-op) and so satisfied with the care I have received from my doctor. She's definitely at the top of her game and I would recommend her to others.
Just as a general update, my doctor said that she could already see the difference from my using the Estrace cream (had been applying nightly since the surgery) and since I was having slight headaches during the day I could cut down on using it to only a couple times per week.
Also for those who are paying so much for their dilators-- when I went to be evaluated by a pelvic floor PT, they tried to sell me some expensive dilators but I declined. Then my doctor told me about vaginismus.com, which sells a set of 4 medical-grade dilators for $44.95.
Someone asked me about the breakdown of hospital and other fees for the surgery:
I have Blue Cross Blue Shield (of TX) and my bill was about $13,000 (then reduced to $3,000 that the insurer would actually pay the hospital) and I am responsible for about $900 total (in addition to the $3,000 that my insurer will pay the hospital), including my $350 deductible (I have really, really great insurance.) Most of the $13,000 were hospital use/equipment fees as well as the anesthesiologist fee. I'm not sure what my surgeon's fee was but this is the breakdown:
Pharmacy - 620.00
Med-Surg supplies - 42.00
Lab - 477.00
Lab-Path - 875.00
OR Services - 8,750.00 (this could include surgeon's fee as well as nurse and anesthesiologist)
Anesthesia - 787.00
Drugs requiring spec id - 10.00
Self-administerable drugs - 4.50
Recovery room - 1,764.00
Friday, December 10, 2010
Monday, December 6, 2010
Dilators, post-op
My doctor gave me the go-ahead to start using dilators. I ordered a set from vaginismus.com and I am currently on the second dilator. I don't have much pain except in the 11 o'clock area.... I think tomorrow I will try the #3 dilator.
I wonder how long I am supposed to continue the dilator use. If I am comfortable with the biggest dilator then can I stop? I will have to ask my doctor.
I am 5 weeks post-op. I still have some stitches but they should fall out soon. My doctor took some out in the office but it hurt so she said we'd just let them fall off.
I wonder how long I am supposed to continue the dilator use. If I am comfortable with the biggest dilator then can I stop? I will have to ask my doctor.
I am 5 weeks post-op. I still have some stitches but they should fall out soon. My doctor took some out in the office but it hurt so she said we'd just let them fall off.
Sunday, November 28, 2010
18 Days Post-op vestibulectomy
I am 18 days post-op and I feel mostly normal. I generally only sit with a cushion and I haven't tried driving yet because I haven't had to go anywhere. I had pain that felt like a generalized burning pain a few days ago but it went away. I am a little bit worried about that since it felt like what it felt like pre-surgery. My doctor said it is probably just the nerves readjusting, or something like that.
I was concerned that I might have an infection because I was running a low grade fever (99-100) for a few days and noticed some swelling on my left labia. However, when I went in to the doctor the next day of course the fever was gone and so was the swelling. She said that the healing looked great and that I shouldn't be experiencing much pain anymore. I haven't had a recurrence of the swelling but I have been running a low grade fever for the past couple days (though not today).
Another problem I had was bleeding from the rectum every time I had a bowel movement. My doctor wanted to make sure that there wasn't a stitch in my rectum so she examined me on Tuesday and said that there wasn't. She also did a CBC to make sure all my blood counts were normal, and they were. I've been continuing to take Colace 3 times a day and drink a lot of prune juice, which I actually like! The bleeding has since gone away (knock on wood).
Right now I'm having a pain that feels kind of deep and at times shooting or pulsating around what I think is the 4 o'clock position. I looked down there and I didn't notice any swelling but my labia looks bruised compared to the other side. Hmm... I feel like I email my doctor all the time and I feel bad about that! I see her again on the 6th of December.
I'm also wondering if it looks the same down there as it did pre-surgery... I don't really remember what it used to look like, though!
I was concerned that I might have an infection because I was running a low grade fever (99-100) for a few days and noticed some swelling on my left labia. However, when I went in to the doctor the next day of course the fever was gone and so was the swelling. She said that the healing looked great and that I shouldn't be experiencing much pain anymore. I haven't had a recurrence of the swelling but I have been running a low grade fever for the past couple days (though not today).
Another problem I had was bleeding from the rectum every time I had a bowel movement. My doctor wanted to make sure that there wasn't a stitch in my rectum so she examined me on Tuesday and said that there wasn't. She also did a CBC to make sure all my blood counts were normal, and they were. I've been continuing to take Colace 3 times a day and drink a lot of prune juice, which I actually like! The bleeding has since gone away (knock on wood).
Right now I'm having a pain that feels kind of deep and at times shooting or pulsating around what I think is the 4 o'clock position. I looked down there and I didn't notice any swelling but my labia looks bruised compared to the other side. Hmm... I feel like I email my doctor all the time and I feel bad about that! I see her again on the 6th of December.
I'm also wondering if it looks the same down there as it did pre-surgery... I don't really remember what it used to look like, though!
Wednesday, November 17, 2010
I am day 7 post-op and I'm feeling a lot better overall. Walking is not difficult. I went on a 15 minute walk earlier this morning. I have pain but it is more of the stretching pain. My doctor says I should not be in much pain anymore.
I have pain but it isn't localized to the 6 o'clock position. It's more around the 4-7 and it's just a general stretching pain. My doctor said she didn't think I'd need them as my "vaginal girth" seemed fine and I don't have any muscle issues but right now I can't think of putting ANYTHING in my vagina. I think it's kind of funny that on my discharge papers it reminds me not to have sex for 4-6 weeks, AS IF I'd even think about that...
Right now I do have some itching. My doctor told me to take benadryl 50mg every 6 hours or to even put benadryl ointment on the site but I think I'm going to just take oral benadryl. She also said she could prescribe me a steroid ointment if the itching continued, but that she would want to see me in her office before doing that (my post-op follow-up isn't until after Thanksgiving).
To those still considering surgery, I think it's important to know your doctor beforehand and know how available he/she will be to answer your questions, especially after the surgery. When I first met my doctor, and especially after a few appts, I knew that if I was going to have this surgery I would want her to do it. It was just a feeling I had about her and it is difficult for me to explain it. My doctor told me she had only done between 10-15 of these but I still felt comfortable with her. I think what stood out to me was that she was extremely sharp with regard to current treatments and efficacies of those treatments. She's only a few years out of her residency and I think, in general, that is a time when doctors are at their best.
There was another doctor in her department who had done "hundreds" of vestibulectomies but he was also really old and a man, which didn't make me feel comfortable. I'm not saying that a man can't do this procedure or be a good ob/gyn, but for me it has always been important to have a female ob/gyn.
I think it can be confusing when we're on here discussing full vs. partial vestibulectomy because my doctor didn't use those terms- she mapped out using the q-tip several times and her fingers as well, exactly where my pain was. She ended up cutting from 2 o'clock to 10 o'clock so I think that is pretty close to a "full" vestibulectomy. I think each vestibulectomy is going to be different though. When my doctor was describing the procedure to the OR nurse she described it as a kind of like a "modified perineoplasty."
I think what is difficult for me is telling my family and friends. My mom is obviously sympathetic and I'm sure she's told my dad but I also have brothers and when I told my older one his response made me feel more alone-- he thought it was TMI. But my younger brother was a lot more understanding and didn't make me feel judged. My female friends and family have all been sympathetic but they don't truly *get* it.
I have pain but it isn't localized to the 6 o'clock position. It's more around the 4-7 and it's just a general stretching pain. My doctor said she didn't think I'd need them as my "vaginal girth" seemed fine and I don't have any muscle issues but right now I can't think of putting ANYTHING in my vagina. I think it's kind of funny that on my discharge papers it reminds me not to have sex for 4-6 weeks, AS IF I'd even think about that...
Right now I do have some itching. My doctor told me to take benadryl 50mg every 6 hours or to even put benadryl ointment on the site but I think I'm going to just take oral benadryl. She also said she could prescribe me a steroid ointment if the itching continued, but that she would want to see me in her office before doing that (my post-op follow-up isn't until after Thanksgiving).
To those still considering surgery, I think it's important to know your doctor beforehand and know how available he/she will be to answer your questions, especially after the surgery. When I first met my doctor, and especially after a few appts, I knew that if I was going to have this surgery I would want her to do it. It was just a feeling I had about her and it is difficult for me to explain it. My doctor told me she had only done between 10-15 of these but I still felt comfortable with her. I think what stood out to me was that she was extremely sharp with regard to current treatments and efficacies of those treatments. She's only a few years out of her residency and I think, in general, that is a time when doctors are at their best.
There was another doctor in her department who had done "hundreds" of vestibulectomies but he was also really old and a man, which didn't make me feel comfortable. I'm not saying that a man can't do this procedure or be a good ob/gyn, but for me it has always been important to have a female ob/gyn.
I think it can be confusing when we're on here discussing full vs. partial vestibulectomy because my doctor didn't use those terms- she mapped out using the q-tip several times and her fingers as well, exactly where my pain was. She ended up cutting from 2 o'clock to 10 o'clock so I think that is pretty close to a "full" vestibulectomy. I think each vestibulectomy is going to be different though. When my doctor was describing the procedure to the OR nurse she described it as a kind of like a "modified perineoplasty."
I think what is difficult for me is telling my family and friends. My mom is obviously sympathetic and I'm sure she's told my dad but I also have brothers and when I told my older one his response made me feel more alone-- he thought it was TMI. But my younger brother was a lot more understanding and didn't make me feel judged. My female friends and family have all been sympathetic but they don't truly *get* it.
Sunday, November 14, 2010
Day 5 Post-op vestibulectomy
I just wanted to update everyone on my progress. I am currently Day 5 post-op (I had my vestibulectomy on 11/9/10). Days 1 and 2 post-op were the easiest and days 3 and 4 the most difficult. I think a lot of the anesthesia and the IV pain meds didn't really wear off until the end of day 2. Anyway, today is the first day (evening, actually earlier today I wasn't) that I've been able to sit at my desk and use my normal computer as opposed to my laptop. I am sitting on a very comfy chair, however. Besides that it has been difficult to walk far. Right now I am in the least amount of pain I have been so far.
My doctor did call me on 11/10 like she said she would- she just called later in the evening. She said she had done the procedure from basically the 2 o'clock position to the the 10 o'clock position. She said she did not want to risk going farther up because it was too close to my urethra. The ice has been a lifesaver but I finally don't need it all the time anymore. Now I have more of an intense itching sensation. It really helps to use the bottle of water to rinse the area with when I urinate. Sitz baths also help.
I had a bowel movement on the morning of Day 4 and it did not hurt (I had been taking colace for about a week) but it did cause some bleeding. The bleeding quickly stopped though. I had been worried about "popping" a suture/stitch but my doctor told me that this was not possible. She said she used a mix of some very deep stitches and then some superficial sutures. The area she cut was about 5mm deep and 1cm wide. I read the path report yesterday and it just stated that there was chronic edema (swelling) and inflammation in the sample.
I am a little bit concerned because one of my labia seems to be bigger than the other, but I'm not in any pain. Things do feel tight down there.
I think it is important to emphasize that everyone heals at their own rate and it is really difficult to predict how one will handle the procedure. I am lucky in that I didn't have any issues with the muscles down there, nor did I have more generalized pain down there. I think (I hope) for me that it was really just this localized pain that this procedure will take care of. My doctor is very hopeful too.
I don't know about going back to work about a week after- I don't think I'd feel comfortable sitting at my desk all day, but I can work from home at my leisure so I am fortunate in that regard.
I will be coming back and giving periodic updates on my progress.
My doctor did call me on 11/10 like she said she would- she just called later in the evening. She said she had done the procedure from basically the 2 o'clock position to the the 10 o'clock position. She said she did not want to risk going farther up because it was too close to my urethra. The ice has been a lifesaver but I finally don't need it all the time anymore. Now I have more of an intense itching sensation. It really helps to use the bottle of water to rinse the area with when I urinate. Sitz baths also help.
I had a bowel movement on the morning of Day 4 and it did not hurt (I had been taking colace for about a week) but it did cause some bleeding. The bleeding quickly stopped though. I had been worried about "popping" a suture/stitch but my doctor told me that this was not possible. She said she used a mix of some very deep stitches and then some superficial sutures. The area she cut was about 5mm deep and 1cm wide. I read the path report yesterday and it just stated that there was chronic edema (swelling) and inflammation in the sample.
I am a little bit concerned because one of my labia seems to be bigger than the other, but I'm not in any pain. Things do feel tight down there.
I think it is important to emphasize that everyone heals at their own rate and it is really difficult to predict how one will handle the procedure. I am lucky in that I didn't have any issues with the muscles down there, nor did I have more generalized pain down there. I think (I hope) for me that it was really just this localized pain that this procedure will take care of. My doctor is very hopeful too.
I don't know about going back to work about a week after- I don't think I'd feel comfortable sitting at my desk all day, but I can work from home at my leisure so I am fortunate in that regard.
I will be coming back and giving periodic updates on my progress.
Wednesday, November 10, 2010
I am SO glad to be on this side of the surgery! I feel such relief. I was terrified before but now I realize there is nothing to be terrified of. My pain today has ranged from 0-3/10. I am able to walk around just fine-- going from laying down to sitting up is a bit painful (a 1 or a 2) in the 6 o'clock position but once I actually sit up correctly I am fine. I try not to sit for too long since I am only on day 1. My doctor did not call as promised, which made me feel irritated but I don't have any questions that can't wait until tomorrow. It just makes me disappointed, I guess, when someone important says they are going to call you and then I have this expectation and then they don't.
I didn't have ice on for most of today. I have it on right now but I don't think I really need it. Urinating is not painful at all and having that squirt bottle to cleanse the area really helps. There is not much else for me to report- uneventful day... not as painful as expected and starting to feel that stretching feeling, which is not painful just a bit uncomfortable. I also haven't looked down there with a mirror yet because I don't want to position myself in a way that could cause pain until I talk to my doctor and okay it with her. I'm supposed to apply estrace cream but I want to talk to my doctor about that-- I think I read on here that someone had used it and it seemed to cause her period to begin early. My period is not due for another 3 weeks and I would like to keep it that way!
I will update you all again once my doctor finally calls me back.
I didn't have ice on for most of today. I have it on right now but I don't think I really need it. Urinating is not painful at all and having that squirt bottle to cleanse the area really helps. There is not much else for me to report- uneventful day... not as painful as expected and starting to feel that stretching feeling, which is not painful just a bit uncomfortable. I also haven't looked down there with a mirror yet because I don't want to position myself in a way that could cause pain until I talk to my doctor and okay it with her. I'm supposed to apply estrace cream but I want to talk to my doctor about that-- I think I read on here that someone had used it and it seemed to cause her period to begin early. My period is not due for another 3 weeks and I would like to keep it that way!
I will update you all again once my doctor finally calls me back.
Hi [name removed],
My doctor also believes that surgery is the only way to cure my vestibulitis. Like you, I only had pain with sex. I used to be able to manage with lidocaine, but as time went on it became more and more painful. Finally, after going to PT and being told that my muscles were essentially normal (when it comes to mind over matter I can do it-- I can relax my muscles for a speculum exam even though I know it will be painful, also same with sex, etc... however, I can't control the pain signals that my vestibule would send to my brain when touched so I decided to have the surgery). I am currently day 1 post op and honestly I feel fine. My pain overall is maybe 2/10 and I don't even have ice on right now. I did take a Vicodin 5 and 800mg ibuprofen but that was a few hours ago. I just walked up and down two flights of stairs to go check my mail and felt completely normal.
Now, obviously I cannot have sex or exercise much beyond walking and other light exercise for the next 4-6 weeks until the incision wound heals, but I'm not on 100% or even 50% bedrest either. My doctor said that I would only be in a lot of pain for the first couple days and then after that I would feel more of a stretching feeling like some women feel after childbirth. I haven't talked to my doctor yet, but I believe that I only had a vestibulectomy from right above the 3 o'clock position to right above the 9 o'clock position (mostly the posterior vestibule).
I know some people on this board and elsewhere have, unfortunately, had complicated, painful recoveries, but it is not that way for everyone. Everyone has a different back story- some people on this board seem to have a pudendal nerve problems, or PFD, or more generalized vulvodynia. I only (so far, knock on wood) had vestibulitis localized in the positions I mentioned above. I could use tampons without pain. I grew up horseback riding. But, for me, 10 years of having pain with intercourse was enough. I didn't want to live/waste another year of my life with that pain. I want to be able to enjoy sex with my hypothetical/future partner as much as a "normal" person. My doctor said the wound would take 4-6 weeks to heal and that the total healing process (e.g., being able to have sex) would take between 4 weeks and 6 months. I've definitely gone longer than 6 months without sex before.
I am generally in good physical shape (i.e., fit) and eat well and this surgery isn't going to change that. I know you mentioned that you were very active and worried about not being able to be active after surgery. I guess it really depends on your doctor and what kind of surgery he/she would do on you. I also noticed that you mentioned your husband would become "angry" when you were not able to finish intercourse yet he does not want you to get "cut" either. This worries me-- I am not a mental health professional-- but anger is a defense mechanism used to control. I can see where he might be frustrated (my longest boyfriend was with me for one and a half years and he was often frustrated, but never angry- especially not during sex. He could be the biggest jerk a lot of the time, but never during sex. He understood that it was simply too painful for me to finish, but there were other ways for him to "finish.") I would encourage you to include your husband on consults with your doctor and have him express his fears so that the doctor could possibly address and allay them. You might also want to see a sex therapist with your husband.
I think it all has to do with getting to the place where you've just exhausted yourself emotionally with the painful intercourse frustration and that kind of pushes you toward being mentally prepared to want to have the surgery. I hope you get there.
I have no idea if my surgery will be "successful" but I am hopeful, and if it not I am sure my surgeon can go in and adjust whatever is not right. Don't resign yourself to a life of painful sex when there are other options. I wish I had had the guts to confront this surgery a year ago but I was in denial to some degree. I kept thinking that this cream or that cream might help, but none of them did. I'm only 29 but I feel like I wasted a decade of my life and that my condition caused all my relationships to fail because what man wants to be with a woman with whom he can't even have sex?
My doctor also believes that surgery is the only way to cure my vestibulitis. Like you, I only had pain with sex. I used to be able to manage with lidocaine, but as time went on it became more and more painful. Finally, after going to PT and being told that my muscles were essentially normal (when it comes to mind over matter I can do it-- I can relax my muscles for a speculum exam even though I know it will be painful, also same with sex, etc... however, I can't control the pain signals that my vestibule would send to my brain when touched so I decided to have the surgery). I am currently day 1 post op and honestly I feel fine. My pain overall is maybe 2/10 and I don't even have ice on right now. I did take a Vicodin 5 and 800mg ibuprofen but that was a few hours ago. I just walked up and down two flights of stairs to go check my mail and felt completely normal.
Now, obviously I cannot have sex or exercise much beyond walking and other light exercise for the next 4-6 weeks until the incision wound heals, but I'm not on 100% or even 50% bedrest either. My doctor said that I would only be in a lot of pain for the first couple days and then after that I would feel more of a stretching feeling like some women feel after childbirth. I haven't talked to my doctor yet, but I believe that I only had a vestibulectomy from right above the 3 o'clock position to right above the 9 o'clock position (mostly the posterior vestibule).
I know some people on this board and elsewhere have, unfortunately, had complicated, painful recoveries, but it is not that way for everyone. Everyone has a different back story- some people on this board seem to have a pudendal nerve problems, or PFD, or more generalized vulvodynia. I only (so far, knock on wood) had vestibulitis localized in the positions I mentioned above. I could use tampons without pain. I grew up horseback riding. But, for me, 10 years of having pain with intercourse was enough. I didn't want to live/waste another year of my life with that pain. I want to be able to enjoy sex with my hypothetical/future partner as much as a "normal" person. My doctor said the wound would take 4-6 weeks to heal and that the total healing process (e.g., being able to have sex) would take between 4 weeks and 6 months. I've definitely gone longer than 6 months without sex before.
I am generally in good physical shape (i.e., fit) and eat well and this surgery isn't going to change that. I know you mentioned that you were very active and worried about not being able to be active after surgery. I guess it really depends on your doctor and what kind of surgery he/she would do on you. I also noticed that you mentioned your husband would become "angry" when you were not able to finish intercourse yet he does not want you to get "cut" either. This worries me-- I am not a mental health professional-- but anger is a defense mechanism used to control. I can see where he might be frustrated (my longest boyfriend was with me for one and a half years and he was often frustrated, but never angry- especially not during sex. He could be the biggest jerk a lot of the time, but never during sex. He understood that it was simply too painful for me to finish, but there were other ways for him to "finish.") I would encourage you to include your husband on consults with your doctor and have him express his fears so that the doctor could possibly address and allay them. You might also want to see a sex therapist with your husband.
I think it all has to do with getting to the place where you've just exhausted yourself emotionally with the painful intercourse frustration and that kind of pushes you toward being mentally prepared to want to have the surgery. I hope you get there.
I have no idea if my surgery will be "successful" but I am hopeful, and if it not I am sure my surgeon can go in and adjust whatever is not right. Don't resign yourself to a life of painful sex when there are other options. I wish I had had the guts to confront this surgery a year ago but I was in denial to some degree. I kept thinking that this cream or that cream might help, but none of them did. I'm only 29 but I feel like I wasted a decade of my life and that my condition caused all my relationships to fail because what man wants to be with a woman with whom he can't even have sex?
Tuesday, November 9, 2010
The day of my vestibulectomy
I had my surgery today. My doctor did answer all my questions. The resident arrived to my pre-op about an hour before my doctor did and so I chatted with her for a while and that helped me feel better. Then when my doctor arrived and asked how I felt, I told her that I felt "really scared" and her response, was "ok, tell me what I can do to help you feel better?" Really great bedside manner. Her demeanor was very laid back and I didn't feel rushed at all. She actually walked with the stretcher as we were going back to the OR and she did the q-tip test one more time to map out where she would cut before I was given ANY sedation. She wanted me to be fully alert for that part. I got to see the stirrups that they use in the OR -- they look like torture devices but they are not painful, just awkward. We did the Q-tip test a few times just to make sure and then the anesthesiologist put me under. (Just another note about anesthesiology- you can ask for them to put an EEG strip on your head so that they know you are truly asleep. I only knew about this because last year I had my appendix out at another hospital and they did that and I asked them what it was for.)
I did ask my doctor for Percocet but in Texas you need a special prescription pad to write for Percocet since it is a CII (triplicate rx pad) and my doctor did not have one. I asked her if the resident could go get it (I thought she meant it that she left it in her clinic or office) and she said that she just didn't have one- that she didn't know of any of the attendings in her department who did since they don't usually write for those drugs. That struck me as odd but I am used to working with cancer patients. Anyway, I asked her if she could give Tylenol 3 and so she did. She also gave me 800mg ibuprofen and some Estrace cream. I haven't used the Estrace cream yet.
We went into the OR at around 9:45 and I was woken up at around 12:45. I was in A LOT of pain 9/10 overall- it felt like stabbing and throbbing. The nurses gave me IV fentanyl up to 80mcg over the course of the next 3 hours and also 10mg Norco and IV diluadid and also IV something that is like motrin, but stronger. After the first few fentanyl and diluadid doses, my pain came down to an 8/10. With the ice on for about an hour and that ibuprofen like IV medication, it came down to 7/10. Finally about an hour before I left they gave me a final fentanyl dose and I felt like my pain was at 6/10. I felt like my bladder was full (probably from the IV fluids) so I went to urinate. It was not painful to urinate, but difficult. I just couldn't get it going. It took me about 10 minutes and I did feel like my bladder was empty at all, however there was what seemed to be a lot of blood in the toilet and that freaked me out a bit. The nurse said it was normal and that it was just kind of built up. After that they thought I was ready to go home so I dressed and got a wheelchair ride downstairs (I put a pillow in the wheelchair and tried to lean back as much as possible-- at that point it was not comfortable to sit).
When I got home I put an already waiting ice gel pack on and took a Vicodin while my friend went to the pharmacy to fill my scrips. My doctor wrote the tylenol 3 to take every 4-6 hours as needed but the anesthesiologist told me to take it every three hours for the first couple days. I just took my first dose about an hour ago (because I had taken Vicodin earlier) so I'll see if it makes me feel better than the Vicodin. The ice is SO SO SO important and I am glad you guys told me about it or I feel like my nurse would not have thought of it (and my doctor did not write it in the orders). When I asked the nurse for ice she had to page my doctor for the ok.
My doctor is going to call me tomorrow because she thought I would be too out of it to talk today after the surgery. She did say that she only expected me to be on bedrest for the first couple days. She said after that I should feel free to do stuff in the kitchen and take short walks, or walk as much as I feel comfortable. She said I could start sitz baths tomorrow afternoon. Also, at the hospital they gave me a squirt bottle that I am supposed to use to rinse the area when I urinate. This is really helpful- I put warm water and he helps me urinate. Also, the urinating is not painful and there is not as much blood AND I can feel like I've emptied my bladder.
Another pain thing that my doctor told me (and nurse and anesthesiologist said same thing)-- if I get my pain to a tolerable point at the hospital and then just keep taking the pain medications as prescribed (instead of waiting for pain to increase) then pain will stay tolerable. Otherwise I could have breakthrough pain.
Of note, I went to one session of PT and that was what finally made me decide to do the surgery. I had virtually no hypertonicity or hypotonicity-- essentially normal. I had been trying oral gabapentin at increasing doses for months, had tried various compounding creams, tried capsacin (painful, just ouch), and things just seemed to be getting worse over the past 10 years or so. Sex used to be manageable with lidocaine but in the past year it was not at all. That and my doctor said she had just been to a conference session on vestibulitis and there seems to be a consensus that this is primarily a disease of neuron over-proliferation, which currently is only solvable by surgery.
I won't know if this worked for some time, but I am hopeful. I am feeling emotionally ok tonight, too, but that may be a lot because I was so well supported by the medical staff (and by my friend who sat with me in post-op and helped me fill scrips, etc) today. I won't have a follow-up visit unless I experience more pain or some other problem for 4 weeks. That seems a long time but it is just as well-- I wouldn't want anyone to be feeling around the wound until it has healed. I'm afraid to look down there. I don't think I will - at least not until the pain subsides a lot more.
Now I need to make a list of questions to ask my doctor tomorrow! I always forget on the spot.
I did ask my doctor for Percocet but in Texas you need a special prescription pad to write for Percocet since it is a CII (triplicate rx pad) and my doctor did not have one. I asked her if the resident could go get it (I thought she meant it that she left it in her clinic or office) and she said that she just didn't have one- that she didn't know of any of the attendings in her department who did since they don't usually write for those drugs. That struck me as odd but I am used to working with cancer patients. Anyway, I asked her if she could give Tylenol 3 and so she did. She also gave me 800mg ibuprofen and some Estrace cream. I haven't used the Estrace cream yet.
We went into the OR at around 9:45 and I was woken up at around 12:45. I was in A LOT of pain 9/10 overall- it felt like stabbing and throbbing. The nurses gave me IV fentanyl up to 80mcg over the course of the next 3 hours and also 10mg Norco and IV diluadid and also IV something that is like motrin, but stronger. After the first few fentanyl and diluadid doses, my pain came down to an 8/10. With the ice on for about an hour and that ibuprofen like IV medication, it came down to 7/10. Finally about an hour before I left they gave me a final fentanyl dose and I felt like my pain was at 6/10. I felt like my bladder was full (probably from the IV fluids) so I went to urinate. It was not painful to urinate, but difficult. I just couldn't get it going. It took me about 10 minutes and I did feel like my bladder was empty at all, however there was what seemed to be a lot of blood in the toilet and that freaked me out a bit. The nurse said it was normal and that it was just kind of built up. After that they thought I was ready to go home so I dressed and got a wheelchair ride downstairs (I put a pillow in the wheelchair and tried to lean back as much as possible-- at that point it was not comfortable to sit).
When I got home I put an already waiting ice gel pack on and took a Vicodin while my friend went to the pharmacy to fill my scrips. My doctor wrote the tylenol 3 to take every 4-6 hours as needed but the anesthesiologist told me to take it every three hours for the first couple days. I just took my first dose about an hour ago (because I had taken Vicodin earlier) so I'll see if it makes me feel better than the Vicodin. The ice is SO SO SO important and I am glad you guys told me about it or I feel like my nurse would not have thought of it (and my doctor did not write it in the orders). When I asked the nurse for ice she had to page my doctor for the ok.
My doctor is going to call me tomorrow because she thought I would be too out of it to talk today after the surgery. She did say that she only expected me to be on bedrest for the first couple days. She said after that I should feel free to do stuff in the kitchen and take short walks, or walk as much as I feel comfortable. She said I could start sitz baths tomorrow afternoon. Also, at the hospital they gave me a squirt bottle that I am supposed to use to rinse the area when I urinate. This is really helpful- I put warm water and he helps me urinate. Also, the urinating is not painful and there is not as much blood AND I can feel like I've emptied my bladder.
Another pain thing that my doctor told me (and nurse and anesthesiologist said same thing)-- if I get my pain to a tolerable point at the hospital and then just keep taking the pain medications as prescribed (instead of waiting for pain to increase) then pain will stay tolerable. Otherwise I could have breakthrough pain.
Of note, I went to one session of PT and that was what finally made me decide to do the surgery. I had virtually no hypertonicity or hypotonicity-- essentially normal. I had been trying oral gabapentin at increasing doses for months, had tried various compounding creams, tried capsacin (painful, just ouch), and things just seemed to be getting worse over the past 10 years or so. Sex used to be manageable with lidocaine but in the past year it was not at all. That and my doctor said she had just been to a conference session on vestibulitis and there seems to be a consensus that this is primarily a disease of neuron over-proliferation, which currently is only solvable by surgery.
I won't know if this worked for some time, but I am hopeful. I am feeling emotionally ok tonight, too, but that may be a lot because I was so well supported by the medical staff (and by my friend who sat with me in post-op and helped me fill scrips, etc) today. I won't have a follow-up visit unless I experience more pain or some other problem for 4 weeks. That seems a long time but it is just as well-- I wouldn't want anyone to be feeling around the wound until it has healed. I'm afraid to look down there. I don't think I will - at least not until the pain subsides a lot more.
Now I need to make a list of questions to ask my doctor tomorrow! I always forget on the spot.
Tuesday, November 2, 2010
This is all so expensive- not just the hospital and surgeon's fees, but all the things I must buy in addition like the sitz baths, the pads, the ice packs, etc etc. I am fortunate to be able to afford it and I feel for those who cannot afford it at all.
I've made a list of questions to ask my doctor on the day of the surgery. I hope I don't feel rushed before they take me in. I assume my doctor will come talk to me before they take me to the OR?
So far my list of questions is as follows:
--when/how to shower?
--what to do when I get my period
--when on bedrest, can I lay on my side?
--what if I have 'breakthrough' pain?
--can I have doctor's pager number/email?
--when do I follow-up?
--when can I sit and for how long?
--when can I walk and for how long should I walk?
--do I need prophylactic antibiotics?
--can I have a painkiller that is stronger than vicodin-- like percocet
Just something else I've noticed- all of Drs Goldsteins' patients gush about them and how perfect and wonderful their experience was. Just thinking statistically that all his patients can't have had perfect results but we don't hear them on these boards...
I trust that my doctor is thoroughly educated by the most up to date research literature, but I will talk to her about full vs. partial and see what she has to say. I feel like I have so many questions to ask on surgery day.
Oh, one more thing-- how long did the actual surgery take? My doctor said it will take about 2 hours.
I've made a list of questions to ask my doctor on the day of the surgery. I hope I don't feel rushed before they take me in. I assume my doctor will come talk to me before they take me to the OR?
So far my list of questions is as follows:
--when/how to shower?
--what to do when I get my period
--when on bedrest, can I lay on my side?
--what if I have 'breakthrough' pain?
--can I have doctor's pager number/email?
--when do I follow-up?
--when can I sit and for how long?
--when can I walk and for how long should I walk?
--do I need prophylactic antibiotics?
--can I have a painkiller that is stronger than vicodin-- like percocet
Just something else I've noticed- all of Drs Goldsteins' patients gush about them and how perfect and wonderful their experience was. Just thinking statistically that all his patients can't have had perfect results but we don't hear them on these boards...
I trust that my doctor is thoroughly educated by the most up to date research literature, but I will talk to her about full vs. partial and see what she has to say. I feel like I have so many questions to ask on surgery day.
Oh, one more thing-- how long did the actual surgery take? My doctor said it will take about 2 hours.
Sunday, October 17, 2010
My doctor said she is not going to remove the Bartholin's glands but that she will transect them, and I'm not entirely sure what that means. She also said that the reason she didn't want to let me sit for 3 hours 2 weeks post-op is because she's not comfortable with me putting that kind of pressure on the site.
I am going to ask my doctor for her pager number, or at least for the pager number of the physician on-call, because I am seriously scared of having some sort of issue after hours and having to either endure pain or worry about whatever issue I'm having. I'm also going to ask her to prescribe a pain medication for "breakthrough pain," though I'm not sure she will. I do not believe in suffering!
I will ask her about the full vestibulectomy, but I have never had pain above the 3 and 9 o'clock positions. She did mention that some women find this procedure gives them relief and then seem to experience the pain again around menopause, so I don't want to be one of those women. She also said having a baby would help, but I can't imagine having a vaginal birth. I am tiny- 100 lbs. It's so hard to find a doctor/surgeon who is an expert in these kinds of disorders, even in Houston which has the biggest medical center in the world.
My doctor is relatively young, but she is sharp and I know she is up to date on all the latest literature. She said that she has only done 15 of these surgeries, which makes me a little bit uneasy, but it is simply cost prohibitive and otherwise not feasible for me to see Dr Goldstein or other doctors. Just buying supplies and medications and paying my insurance deductibles + 20% of all other fees is costing a ton.
One question I have: can someone tell you've had surgery a few months after just by looking down there? I mean, does it look different? My doctor told me it wouldn't look different.
One of my guy friends is going to take me to and pick me up from the surgery. I wish I had a boyfriend/fiance/husband like so many here seem to have, but I've found having VVS precludes those relationships. It's really hard to tell people about my condition- I often feel so alone. I finally broke down and told my mom only yesterday. I feel like I'll be okay physically when I'm back at my apartment by myself, but emotionally is another story.
It all seems so unfair. I know things could be worse, I could have cancer, for example, but I just wonder what it is like to have sex and not worry about pain and not spend a ton of money on failed treatments and also all the time I've spent going from doctor to doctor. All I want is to find a man and start a family but I can't because of this. It has taken me several failed relationships to get to the point where I want surgery.
Did anyone here have trauma to vestibule that preceded the pain? When I was about 5 years old I was in the bathtub with my cousin, who was playing with this mechanical swimming frog... anyway someone the frog injured me around my vulvar area and I required stitches, etc. But I didn't become aware of the pain until I became sexually active in my early twenties. I always wonder if that frog incident is what caused this. Sorry for the tangential story... I appreciate everyone's advice and comments and I will definitely keep posting on my progress/experience after the surgery.
I am going to ask my doctor for her pager number, or at least for the pager number of the physician on-call, because I am seriously scared of having some sort of issue after hours and having to either endure pain or worry about whatever issue I'm having. I'm also going to ask her to prescribe a pain medication for "breakthrough pain," though I'm not sure she will. I do not believe in suffering!
I will ask her about the full vestibulectomy, but I have never had pain above the 3 and 9 o'clock positions. She did mention that some women find this procedure gives them relief and then seem to experience the pain again around menopause, so I don't want to be one of those women. She also said having a baby would help, but I can't imagine having a vaginal birth. I am tiny- 100 lbs. It's so hard to find a doctor/surgeon who is an expert in these kinds of disorders, even in Houston which has the biggest medical center in the world.
My doctor is relatively young, but she is sharp and I know she is up to date on all the latest literature. She said that she has only done 15 of these surgeries, which makes me a little bit uneasy, but it is simply cost prohibitive and otherwise not feasible for me to see Dr Goldstein or other doctors. Just buying supplies and medications and paying my insurance deductibles + 20% of all other fees is costing a ton.
One question I have: can someone tell you've had surgery a few months after just by looking down there? I mean, does it look different? My doctor told me it wouldn't look different.
One of my guy friends is going to take me to and pick me up from the surgery. I wish I had a boyfriend/fiance/husband like so many here seem to have, but I've found having VVS precludes those relationships. It's really hard to tell people about my condition- I often feel so alone. I finally broke down and told my mom only yesterday. I feel like I'll be okay physically when I'm back at my apartment by myself, but emotionally is another story.
It all seems so unfair. I know things could be worse, I could have cancer, for example, but I just wonder what it is like to have sex and not worry about pain and not spend a ton of money on failed treatments and also all the time I've spent going from doctor to doctor. All I want is to find a man and start a family but I can't because of this. It has taken me several failed relationships to get to the point where I want surgery.
Did anyone here have trauma to vestibule that preceded the pain? When I was about 5 years old I was in the bathtub with my cousin, who was playing with this mechanical swimming frog... anyway someone the frog injured me around my vulvar area and I required stitches, etc. But I didn't become aware of the pain until I became sexually active in my early twenties. I always wonder if that frog incident is what caused this. Sorry for the tangential story... I appreciate everyone's advice and comments and I will definitely keep posting on my progress/experience after the surgery.
Saturday, October 16, 2010
(Note: these are entries that I posted to a vestibulitis forum online.)
I am having my surgery in Houston with Dr Anuja Vyas from the Baylor Clinic. I am most afraid of the post-op pain at this point. She didn't tell me how long I'd need to be on bed rest, though she did say that she wouldn't be comfortable with me sitting for a 3 hour drive two weeks post-procedure. She also didn't mention anything about ice packs or sitz baths or stool softeners so I am thankful for this forum! I have written down a bunch of questions that I will ask her on the day of surgery. I think mine is only a partial vestibulectomy because I only have pain between the 3 and 9 o'clock positions. She says that the wound itself should heal within 4-6 weeks and that mostly I will feel a stretching feeling/pain. I hope I am able to drive home (3 hours away) in time for Thanksgiving.
I'm wondering what I will do when I get my period approx. 3 weeks from now- do I have to use pads? I haven't used pads since middle school ;-/ but I'm guessing so. I might ask her if there is a way we can delay my period, like by having me start oral contraceptives or something, though I am thinking probably not since I am already 7 days in. How long after your surgery was your first follow up appointment? I am told she will use stitches that dissolve.
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