Physical Therapy

So today was my first day of physical therapy, more specifically pelvic floor therapy. I went with a friend to an office about 20 minutes away from school. Going in, I had little expectations, probably because I had no idea what to expect. I think I have purposefully researched very little about physical therapy so I wasn't disappointed. 

First of all, I'll ask the stupid question, what does one wear to vagina physical therapy?? I ended up going in my tennis gear because I went straight from hitting. Second of all, I had hoped that I'd be in my own little room so I wasn't going to be sitting next to some football player who tore his knee. Although that would have been quite the experience. So my physical therapist comes out and takes me into a small room and we go over my entire history with vulvar vestibulitis. I swear, it would have made both our lives easier if I had just given her this blog. But it's alright, I've gotten rather good at recounting what has happened in a short period of time. 

After our little chat, she gave me a sensor that I had to insert that was going to test my pelvic floor muscles and see how tense they are and when they contract. I couldn't find an exact picture, but this one seems pretty accurate. http://www.biolifedynamics.com/xcel-01.gif

So, I inserted the bottom part which then hooked up to a laptop. Then we tested my rest rate of my pelvic floor muscles- they were about 3 (Don't ask me what this number means) and they are supposed to be at 1. But my therapist said they weren't as high as she's seen. Then, I did three exercises where I squeezed my muscles for ten seconds and then relaxed them.

I now have three different exercises I'm supposed to do twice a day, as well as a breathing method I'm supposed to practice. Although I said I went in with no expectations, I guess I was hoping my pelvic muscles would be really bad and that would be the root of all my problems. But, I talked with my therapist and she said it seemed like having vulvar vestibulitis was causing my muscles to tense since I was expecting pain. It wasn't that my muscles were bad to begin with and causing the vulvar vestibulitis. So, even after doing all these exercises, it's only going to help me DEAL with VVS and not help SOLVE the actual problem. And that's just frustrating. But on a positive note, although it hurt like hell to get the sensor in and out, the pain didn't last longer than 10 minutes afterwards. A month ago, I would probably be in tremendous pain the rest of the day. So, small steps, small steps. I go back for the next three Mondays before I leave for Africa, so we will wait and see if I improve. 

Second Set and still fighting

This will have to be a short update because I have a really busy day ahead of me. I'm a little confused right now because it still hurts the same to insert and apply my two creams, yet I'm not noticing as much daily pain anymore. Am I finally getting better? Or am I so distracted on a daily basis that I have learned how to forget about the pain?

I would like to think that I'm getting better. After my tennis match yesterday, I realized I've been fighting VVS the same way I play my tennis matches. Yesterday I lost the first set 6-4 and came back to win the next two 7-5 and 6-1. In my whole tennis career, I've lost one match that I brought to three sets. My dad thinks its because my mental game is stronger than anyone he knows. Anyway, I feel like the beginning 8 months of having VVS was my first set. I was frustrated, upset, and my head wasn't in the right place. Lately I've started the second set and have slowly been fighting my way to bring it to a third set. I have my first physical therapy appointment on Monday. I'm very nervous because I have no idea what to expect or what I'm going to do. If I'm still in so much pain applying my creams, how am I going to get through therapy right now?

Some people have told me that continually saying I am "fighting" VVS and that this is my "battle" is not the best way to view it. They advise to take a more peaceful approach. However, I believe that being in this mindset, just like I am in a tennis match, has helped me tremendously over the past couple of weeks. 

In other news, I'm giving my activism presentation on VVS to my class tonight. It's going to be a little different than the WILL presentation because these are people who don't know me too well. Hopefully they learn something new and spread their knowledge until another girl who is going through the period of misdiagnosis realizes she's not alone.

Specialist Visit

I apologize for the lack of new posts, but I wanted to wait until after this past visit to the specialist. Like I said, my mom had to work today, so my dad came to school and we left for Philly together this morning. I want to pack a lot of information into this post, so I'm going to rush through the exam. For the first time, I didn't have tears in my eyes when my specialist examined me. It was still very painful, but nothing like the last visit. I usually have difficulty walking and sitting after the exam, but today I was fine.

During the discussion with my specialist, a lot of information was brought up which I'm going to do my best to relate right now. He discussed in detail all the possible treatments available for VVS. The first step is to to try applying the steroid cream in hopes that the chronic inflammation will decrease. After that attempt, you try applying the Estrace cream. If that doesn't work, you move on to taking a pain medication, which is usually an anti-depressant (Elavil in my case.) Then, if your body cannot handle the anti-depressant, you use a cream form of the drug along with an Estace cream. This is how far I've gotten. Now I was told all the other possible treatments and was given the choice of what I would like to start. I'm going to put all my options in list form below in order to make it easier to read.

-Series of steroid shots- The theory is that the steroid cream isn't penetrating deep enough into the vulva to make a difference, but shots can reach deeper places and hopefully decrease the inflammation. There are several problems with this treatment. You must get a series of steroid shots ONCE a week for TWELVE weeks (very time consuming) AND these are long needles going into a place that I still can't tolerate a q-tip touching.

-More pain medication- There is also the option of taking Neurontin which is an anti-seizure drug. It wouldn't affect my mood, but it still has the side effects of drowsiness and dizziness. I had a lot of problems on Elavil and was so limited in what I could do and wouldn't want that to happen again.

-Pelvic Floor Therapy (Biofeedback)- This is the physical therapy route that deals with the pelvic floor muscles. Apparently upon examination, my muscles are extremely tight and tense. I can feel myself tightening up right before an exam because I know the pain is coming. I was given a list of PFT therapists, and one is located right in Hamilton Square by school.

-Surgery- This is what I talked about last post- it's called a vestibulectomy and involves cutting out the bottom half of your vulva, folding new skin over the area and stitching the vagina back up. This is what my friend has recently had, and I'm curious to see if she is cured. I would be in a lot of pain the first week, and not be able to play tennis for 6-7 weeks. Apparently surgery cures 70% of those who attempt it, 20% of women improve, and 10% stay the same.

At this point, I opted to go the physical therapy route. I am going to remain on the Estrace and Elavil cream because they seem to be slowly working. My estrogen levels have now returned back to normal. I am trying to get into therapy before I leave for Africa on May 20th.

Other interesting information:

Although there has been a correlation between VVS and birth control- birth control isn't believed to cause the condition. Extensive research has been done that shows it is a genetic disease and that I was born with more nerve endings and chronic inflammation and that a small event triggered these problems to arise.    

For the first time, I came back from the specialist hopeful. I am excited for therapy and also the knowledge that I have other options to fall back on if it's not successful. I want to thank my dad for accompanying me today- it meant a lot. And I also don't want to forget to thank my mom who has repeatedly come with me. Again, I don't know what I would do without such a strong support system. 

I am too tired to think if I have left out any other information. It was a very informative day and I hope some of the things I wrote about today will help at least one other person. I thank all those who continually check this blog- it means the world to me. Please continue to read and please comment! (you are welcome to be anonymous) I want this to be more of a forum for people to share their own experiences, exchange medical information, or even just a place to vent. And it's important to note that you don't have to have VVS to comment. Feel free to talk about any part of your day that was depressing or stressful. Trust me, you'll feel much better after talking/writing about it. Good night all!

And I'm Feeling Good...

Before I begin, I recommend listening to "Feeling Good" by Nina Simone. It goes along perfectly with this post.

Where to begin? I'm so excited to finally write a happy post. My life has turned around completely and I'm finally beginning to leave this state of anger and denial. This past weekend, the 28th- 30th, I decided to go to a blues dancing exchange in Pittsburgh on a whim. I wasn't able to go with my tennis team to upper New York because of the flu/back problems from the car accident. So my good friend Kerry and I, along with Lucky (a young blues teacher from NYC) drove the 6 and a half hours to Pittsburgh and had the time of our lives.

I focused that weekend on making myself happy. I probably danced for 28 hours and slept for 6. And I also met someone. Details aside, it was a big step for me, and it was nice to know that even with VVS I've still got it and am not broken. It was just a big self confidence boost that was greatly needed. I was even able to tell him about my condition and it didn't scare him away. So, to all the men in the world, I haven't totally written you off just yet.

After that weekend, I have just been on this high- I won my doubles tennis match on Saturday, I'm getting involved with a blues dancing documentary... I have been having fun. I think it's so helpful to take the time and make yourself happy. I also think the medicine has finally left my system and my body has regulated itself. People have been noticing the difference in my attitude. Finally! Tamra is back! 

Tonight I made a presentation to WILL (Women in Leadership Learning) with the help of Debbie about being diagnosed with VVS. We always do a presentation at the end of class about women and health- this time Debbie played the role of several doctors and we acted out a shortened skit of my basic story. At the end I told these women the story was actually about me and gave them my blog to read, so hopefully that many more women will now know about VVS. It was a big step to "perform" this presentation and I feel so free after doing it. I have another presentation coming up in two weeks to my class, and then some high school presentations after that. It gets easier each time.

I'll end on a health update on how I'm doing. So far I'm not responding to this medication and I still hate taking it. I go back to the specialist on the 15th and this time my dad is taking me because my mom has work. I'm so happy he took off work and is going to be there for me. He's been so understanding and motivational- I couldn't ask for a better support system. I only hope I find someone who's half the man he is someday. I also recently received a message from someone who has VVS which I'd like to share. She said she saw Dr. Goldstein- one of the top specialists in the US for VVS and he told her she has primary VVS, which means it is a birth defect that she was born with. He said she was born with 10-20 more nerve endings than normal which causes the pain. Dr. Goldstein said the only way to get rid of primary VVS is surgery. I'm going to look into this further and ask my specialist in a week if this is the case. 

I also have a friend who is going through the surgery as we speak. If you want to know more, it's called a vestibulectomy. It is usually the last resort and is a very difficult and draining surgery. I think about her constantly and hope she recovers quickly. It would be another glimmer of hope for me if she is cured. 

Well that was a lot for one day. Thank you everyone for reading. This blog has already been viewed 1,300 times- which means that many more people have now been educated. Yes, I'm still living with a lot of pain. But I don't dwell on it anymore because I've been so happy recently. Dancing has really become my medication and makes me forget. I have surrounded myself with wonderful friends and family. I really couldn't be more blessed. Thank you.