Valium for the Vagina!

I haven't been this excited in a while. And, based on the title of this post, yes I am putting valium in my vagina. Here's the concept:

Valium (diazepam) is a muscle relaxant that can work locally on muscles in what is medically termed "pelvic floor muscle dysfunction" and there is a correlation between this and vestibulitis. A study looked at the levator ani muscle in particular in its assessment and then the women's pain responses.

Doesn't valium zone you out? Nope, used locally it has no systemic side effects like sleepiness. The article and my psychiatrist both say this (although the study shows a caveat).

What do you do? Insert 5mg to 10mg of valium up to 3 times a day (I am trying 5mg once a day) in tablet form with a bit of water on the pill, crushed and mixed with an oil or lubricant, or in a compounded form from a pharmacy.

21 women were studied who had done many other therapies without adequate results. They chose the amount and the means of insertion. The results were an overall pain decrease (not just the vestibule) as they were being seen for pelvic floor dysfunction (which includes vulvodynia but also other diagnoses). Their pain rating went from 5.9 to 2.2 (on a 10 point scale) and their levator ani muscle pain (created during their assessment before and after the study. Fun.) went from 38 to 1.8. This was over 1 months duration.

A small study...still the success rate was 62% (in the success range of vestibulectomies). None had worse pain. 7 women reported no improvement. A few women reported some drowsiness, but it did not affect their functioning.

I am pretty thrilled to try this. It is easy, conservative treatment. My psychiatrist prescribed the valium noting, "Now, I am writing this up as orally dosed, but obviously you won't be taking this orally!" I love her and she has been a big partner in reducing my pain.

The article was written up by the researcher Donna J. Carrico, WHNP, and MS in the Winter 2011 National Vulvodynia News, Volume XVI, Issue 3. She is a nurse practitioner at the Women's Urology Center at Beaumont Hospital at Royal Oak, Michigan. From the article, I don't sense that a formal study has been published in a journal.

Inflammation and Allergies

So, I have lots of signs of general body inflammation: genital skin pain, bursitis in my hips, and arthritis in my hands. I also have allergies and it occurred to me that I should see an allergist and find out what I am allergic to right now (allergies can change). So I went to the allergist a.k.a. an immunologist. Usually when you see an allergist, you get your pinpricks of allergens on your back, get a list of things to avoid, and start doing diet or lifestyle work-arounds, meds, or injections. I decided to grill him whether there was a connection between allergies and other inflammatory diseases. He is up to date on the data and said that there is not enough research. For most people, there seems to be no connection, but for som people it seems their allergies and other autoimmune illnesses are connected.

I have taken my anti-allergy steps and feel so much better in the morning without being congested. Maybe it won't "cure" what else ails me, but it feels good anyway - a healing experience in itself.

Update: I have reduced my allergic load by cutting out the food and environmental factors that flare me. I have cut out the foods I respond to: cranberries, chocolate, apricots, tomatoes, sweet potatoes. I have added mite covers on my bedding (google this to learn more), moved my bed to a wall that I am confident doesn't have mold - my bed was up against a 64 year old shower and tub wall, and moved a plant out of my room. I can't believe the difference. No sore throat, no post nasal drip, less swollen eyes. I have to think it is helping my vulva

Sacrum Stabilizing Exercises

I just posted my current exercises on youtube.com. Use http://www.youtube.com/watch?v=KIBYVTJEqzs or "sacrum stabilizing exercises" in the search box. My "channel name" is vestibulitis. The exercises are really helping my sacrum pain. That, plus the serola belt, plus the shoe lift are getting me pretty far. The biofreeze, regular exercise, Klonopin tablets (not the pills but the oral tablets), upped anti-depressants, and avoiding "unwise activity" are getting me the rest of the way there most days. I am feeling much better and can do more.

"Unwise activity" is a term used in the book "How to be Sick"; I found this book helpful in having mental strategies when I am in pain. Unwise activity in my life can be gardening, cleaning, cuddling in bed, and sitting down too long, as examples.

Hyaluronic Acid and Omega 3 Supplements Were Suggested

Update February 23, 2012:
I heard from my rheumatologist that hyaluronic acid is not going to any good (or bad) for me. She strongly endorsed Omega 3s and suggested that I stick to flax based supplements because fish based ones aren't controlled for toxicity by the FDA). I have found that an even better way to get my Omegas is through ground flax seeds and chia seeds. I buy them at Whole Foods and throw them on or in anything. Tastes really good and are now "must haves" in my morning cereal.

I also talked to doctors and researched delayed response allergy testing and am not confident in its reliability and so I went down the typical allergy path. By avoiding my food allergies and containing my environmental allergies, I feel better overall.

Original Blog:
My insurance company has assigned me a "health coach" (are my bills too high for them?) and I happened to get a doctor who will work with me who specializes in chronic pain and dermatology. Doesn't that sound like vulvodynia? During our one hour conversation, she suggested that I really up my Omega-3s to 4000mg/day and also take hyaluronic acid orally (when I went to the store there are creams made of this and when I asked in pill form I almost got acidophilis (not sure why so watch out)to 4000mg/day. The hyaluronic acid can apparently strengthen ligaments. I bought Hydraplenish by Nature's Way at Whole Foods. She said to take the hyaluronic acid for 2 weeks to see if I got improvement. I am on day 4. She also suggested I consider delayed allergy response testing (different from regular allergy testing) and I might look into this. Her general take was that I have a lot of inflammation and that needs to be managed down. I will talk to her again on December 6th.

Bursitis - A Cause of Pain? What to Do?

Thinking that the source of the pain is bursitis is a lot less scary than thinking it is pudendal nerve entrapment. So, perhaps bursitis in my hip and in a number of other places in my pelvis is contributing to the pain. My doctor sticking her finger into a bursa HURT! Here's what I am doing to get relief and overall improvement:

1. Avoid "unwise action". I worked in my yard two weeks ago and had a major flare thereafter. Totally not worth it although I enjoyed myself at the time;
2. Use Biofreeze, a menthol based roller-stick rub on whereever you have skin burning, except the vulva!;
3. Use lidocaine and rub it on your vestibule and wherever you have skin burning;
4. Don't massage yourself thinking it will improve things. All it does is inflame the bursa;
5. Take ibuprofen during a flare;
6. Take physical breaks - nap;
7. Wear your sacral belt unless it is pressing on the bursa. And, in general, don't wear the belt too tightly. The instructions say to only have it as tight as you tie on a pair of running shoes.
8. Do your P.T.

Tips 1 through 5 are the most important for me.