Block!!! Absolutely, completely, totally but only if you know where…
I have to stress this post completely relates to my condition and my personal issue with Pudendal Neuralgia. I also have to state that while I document my treatments and their effects it is difficult to know whether the effects will last. That also explains why my post is written so much later than my first nerve block (Dec 2011) and will end with ‘stay tuned’.
December 7, 2011
If you’ve been following my story then you’ll know by 2011, four years post accident, I had discovered, what I’m quite sure is, the second main culprit of my injury (the first being a nasty pelvic ligament), the Pudendal Nerve. A sequence of events found me in Dr Peter Courtney’s hands who suggested we block this nerve (bilaterally) and also inject both Sacro-Illiac (SI) joints with some cortisone as they were quite bulgy, especially on the opposite side of my injury (overworked poor darling!).
Nerve blocks affect us differently but the trickiest part about the Pudendal Nerve block is that it is quite painful and ideally requires a full anaesthetic which means the blocks must be a minimum of 12 weeks apart. So if my nerve block didn’t give me relief it either meant we missed the spot (hardly unlikely in my case) or that this treatment wasn’t going to work for me. I didn’t get 12 weeks of complete relief but certainly it reduced my pain and I had many moments of total relief and some random full days too. As documented many times with this condition, treatment isn’t just about relief, it also provides more detail about the issue and this becomes a guide for the next step. It’s like taking mini steps of progress and it really feels fabulous, I feel as though I gain some control, I foresee future options and ultimately, I regain some hope. Without this I’m travelling blindly.
The main aims for a nerve block are pain relief, diagnosis and obviously a cure. Cure happens, research tells us, if the block gives long-term relief and the nerve relearns how to behave during that time (or as I prefer to believe finally gets its sedative, has a long rest and recovers).
I feel quite lucky to be tuned in to my body and able to explain how I’m feeling and what pain I have and where. During this first block I noticed the rectal branch of the nerve was not affected so sitting back, completely on my behind with my back to a chair (not supporting my upper body on a table or my hands) would trigger the pain immediately. I’d feel a heat begin, a zinging then eventually I’d have the flare up. I explained this detail to Dr Courtney and it gave us a huge lead for my second nerve block…
April 18, 2012
I began to really struggle 12 weeks after the first block and even during that time I had a few flare ups. I wondered if my implant perhaps had interfered with my nerve block as it’s known to cause pain if you keep it on whilst the pain is at a low-level (yes, try to figure that one out!!) By the time I realised my nerve block was well and truly wearing off I was at the 14 week mark, and having been very excited with what relief I had, Theo and I booked a holiday to Italy. Thankfully the brilliant Dr Courtney was able to fit me in for another nerve block at the 19 week mark which was exactly two weeks before travel time. Why am I mentioning the holiday? Because I believe a nerve block needs support, it needed me to get out of the pain routine and team it up with as much distraction as possible… oh and a little bit of pain medication in the form of Endep (not the mammoth amounts I had previously tried that were horrendous). I felt my brain would freshen up, have a new shot at life and not have to face my day bed, aids, daily pain routine etc etc. I set off to live a dream in hope distraction would bring a positive change and another step forward. Ok I’m lying, I was hoping for a complete cure so that I could return to my life after a brilliant Italian escape and work 9-12 hour days again while preparing a new exhibition and doing my yoga four times a week. (Sorry, went off the track a bit there… where was I?) Yes, nerve block time, I’m talking to Dr Courtney.
So Dr Courtney’s brilliant idea was to try to block the rectal branch of the Pudendal Nerve which apparently is quite hard to get to. Next I heard and remember was a blur like this: “longer needle… zzzzz, is it here… zzzzz, what about here… zzzzz, and now..?” oh my God that kills!!!!! zzzzz, “We’re going to roll you over to the bed now Soula” perhaps it’ll fix me if I fall off… zzzzzzzzzzzzz… wake up blissfully on my back…. honey I’m starving… zzzzz…. yuum, I feel great, let’s go home!
I’ve returned from my Italian holiday, Dr Courtney certainly hit the rectal branch of my Pudendal Nerve (right side) and I have had much relief again. But this time, I began Endep, just a 1/4 tablet every second day, working my way up through our holiday to 3/4 per day (and more dopey unfortunately!). BUT my implant was off the whole time. I also picked up a miracle new tip while travelling. I am at ten weeks post block with low-level pain and although this is with limited capacity I am happy to say overall my ability has finally had a step up.
So if you’re asking me to block or not to block? Today, I’d say 100% block! But… stay tuned!