# vulvodynia with non-epi birth... how do I possibly do this??



## FondestBianca (May 9, 2008)

I WAS having a smooth pregnancy up until about a month and a half or two months ago. My vulvodynia that had finally went dorment (with medication) after the delivery of dd in 05 decided to flare up again. My EDD is Dec 1st and this time the medication that was my miracle cure (and also the only mediation avaliable) didn't work







. The only thing left is a 50/50 shot with a long drawn out physical therapy process. I begin that next week but have been told that it is doubtful it will be effective (if effective at all) by my due date. The pain has progressed and has now gone from muscle pain only to muscle and tissue pain. This has also sparked my interstitial cystitis to flare up again as well. Both are currently on my plate.

I planned to do an epi and IV narcotic free (the IV narcotics make me throw up anyway so thats out for more than one reason) birth and even hired a doula to help with pain management. But, when the vulvodynia did return I must say that I was comforted and calmed by the fact that if it got HORRIBLY painful and the baby started to become stressed and I started passing out (like what happened with my labor with dd) the epi was avaliable to ultimatly help me avoid a section because I wasn't staying consious.

BUT, recent testing has found that my platelet levels are lower (and dropping) than the minimum requirement for the hospital to allow an epi or spinal. So that means I have no choice but to go without for the entire labor. I just can't imagine how the stretching and possible vagional canal tearing will feel with the vulvodynia and no epi when even a routine cervix check is painful at this point 2 months prior to my due date.

how do I do this? it's getting harder to imagine with each passing day.


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## nashvillemidwife (Dec 2, 2007)

What type of pain do you have? There may be other treatments. You can start pressure point release that might help with muscle pain. A lot of women with vestibulitis have successful treatment with lidocaine injections. As for labor, what about local anesthetic like a paracervical block?

I have severe vestibulitis and am having a homebirth, so I have trouble even putting my mind where yours is as far as pain relief. Maybe it's because mine is chronic. I figure I've lived with this pain for so long that the few moments it takes to push a baby out past it is nothing. I guess what keeps my anxiety down it is knowing that since I'm going to be at home with midwives, I'm not going to have other people's hands in there making the problem worse or telling me to push when I'm not ready. I recommend you talk to the doctor and nurses and explain to them about your pain, and ask that they keep their touching and coaching to a minimum.


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## FondestBianca (May 9, 2008)

Quote:


Originally Posted by *nashvillemidwife* 
What type of pain do you have? There may be other treatments. You can start pressure point release that might help with muscle pain. A lot of women with vestibulitis have successful treatment with lidocaine injections. As for labor, what about local anesthetic like a paracervical block?

I have severe vestibulitis and am having a homebirth, so I have trouble even putting my mind where yours is as far as pain relief. Maybe it's because mine is chronic. I figure I've lived with this pain for so long that the few moments it takes to push a baby out past it is nothing. I guess what keeps my anxiety down it is knowing that since I'm going to be at home with midwives, I'm not going to have other people's hands in there making the problem worse or telling me to push when I'm not ready. I recommend you talk to the doctor and nurses and explain to them about your pain, and ask that they keep their touching and coaching to a minimum.

at it's least it feels like an uncontrollable and very painful contraction of all of the pelvic muscles (also causes constant swelling) and at it's worst it is the horribly painful muscle contraction and burning tissue pain that when touched feels EXACTLY like someone scraping off 3rd burned skin. The only medication avaliable only helps control the swelling in hopes that wihtout that your body can sort out the other issues on it's own. Basically the condition is a combo of loss of control of muscles (they kinda do their own thing and freak out), and swelling and pain caused by confused pain recpetors sending the message to your brain that says, "hey we're injured down here and IT HURTS!" and thus, you feel pain. Other medical issues, stress, and randomness make it worse. It doesn't go away really, it can go dorment but, it also has the potential to be apparent and causing discomfort and pain your entire life. My first bout lasted about 2 to 3 years non stop and only got worse with time... until I was finally diagnosed after ruling everything else out and given meds for the swelling. There is no telling if it will work or not but, it did and I didn't questions why. This time I was convinced it would work again... but it didn't.

I'm not sure about the local you're talking about. I'll have to look that up.

I also have no indication that pushing the kid out will just be "a few minutes". With dd the swelling from all of the trama to the area caused her to be stuck in nearly crowing position for 3 hours. I PUSHED for 3 solid hours. I also tore on the inside due to the swelling from the vulvodynia. The more I dialated the more my body mistook that dialation as injury and caused more swelling and sent the message to my brain that it is more painful.... basically it sucked... and I ended up with an epi i honestly i think thats the only reason i was able to avoid passing out from shock during the pushing phase (I had already passed during labor.... when I was only at a 4 and 6!) and avoiding a c-section.

the vulvodynia isn't as bad this time but, not good either.

i'm just nervous... half of the issue is that when my body starts to do things I can't control (like labor contractions) I go into panic mode for no logical reason. I have to focus very hard to just avoid hyperventaling or having a panic attack. If I can get used to something I calm down and am fine but, if I freak out before I have a chance to get used to it well, then... its a mess.

to add, right now we dont' have any extra money for your more alternative treatments such as massage, acupuncture, reiki, etc.


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## wumanh (Apr 30, 2005)

Can you check out alternative treatments like acupuncture or homeopathy?
How about hypnosis? or other energy work like EFT or TAPAS?
St. John's Wort is great for nerve pain. Oil directly to the area if you can bear the touch. or tincture by mouth- try 1 dropperful in a little water.


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## FondestBianca (May 9, 2008)

Quote:


Originally Posted by *wumanh* 
Can you check out alternative treatments like acupuncture or homeopathy?
How about hypnosis? or other energy work like EFT or TAPAS?
St. John's Wort is great for nerve pain. Oil directly to the area if you can bear the touch. or tincture by mouth- try 1 dropperful in a little water.

right now anything that costs more than a few bucks (yes, literally, a few) isn't an option. I'll look into the st. johns. I had no idea it could be applied externally! i can bear touch so that could be an option. anything slightly invasive is out but if I can do it myself i can manage just fine.


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## HarperRose (Feb 22, 2007)

The homeopathic form of St John's Wort is Hypericum Perforatum. That's only a few bucks, too.








You've really got more than your fair share of crap to deal w/ right now.


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## FondestBianca (May 9, 2008)

Quote:


Originally Posted by *Justthatgirl* 
The homeopathic form of St John's Wort is Hypericum Perforatum. That's only a few bucks, too.








You've really got more than your fair share of crap to deal w/ right now.

haha yah. i do have a very good deal of good things going on too luckily.









this is just one of the not-so-fun things.


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## HarperRose (Feb 22, 2007)

Quote:


Originally Posted by *FondestBianca* 
haha yah. i do have a very good deal of good things going on too luckily.









this is just one of the not-so-fun things.

Well at least there's some positives going, too!







:


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## FondestBianca (May 9, 2008)

Quote:


Originally Posted by *Justthatgirl* 
Well at least there's some positives going, too!







:

dd is healthy and happy. dh is healthy and happy. both dogs and both cats are healthy and happy. both dh and I's parents and siblings are healthy and happy. both of our cars are healthy and happy. my zillions of house plants are all healthy and happy. little ds in my belly seems to be healthy and happy. house is clean, food to eat, bills are still getting paid. thats nothing to shake a stick at!


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## nukuspot (May 10, 2007)

I don't have VV, but I DO have Interstitial Cystitis! So I understand the worry about chronic pain, especially in the pelvic/vaginal region, and birth. My IC has flared up badly with pregnancy, I had it under control (with medication and diet) for about 2 years before getting pregnant...But now it is back, even though I stick to my diet like crazy, and even started taking a (low dose) of my medication (category B) again (though I had to stop d/t prolonged morning sickness!)

Anyway, I am planning an unmedicated homebirth, and I plan to rely on water (like a birthtub) to get through it, since warm water calms my muscles and helps the IC. I used to get pelvic floor physical therapy like you are thinking about for related pelvic floor dysfunction...And have thought about restarting it, but worried it might be too intense while pregnant?!

If it helps, I have been collecting vaginal birth stories from other women with IC (some of whom have VV, as it can be a related condition) and many women say that they didn't focus on their IC pain while pushing, as the contraction/birth sensations were more intense.) So I hope it will be the same for you too. I'm not totally in the same boat, but similar, and I am there with you!


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## Defenestrator (Oct 10, 2002)

What about a pudendal block? I have seen that used in the past for a woman who had a very hard time relaxing her perineal muscles.


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## Curlita (Jan 10, 2005)

Hi, Vulvar Vestibulitis veteran here. And a VBACer. I had an unmedicated birth a year ago tomorrow. My VV was not flaring at the time, but honestly, I think that there is so much going on during labor that the VV pain is completely masked by the normal pains of birthing and labor. I second the suggestion of laboring in water -- it's supposed to be helpful for stretching the tissue. And talking to your midwife or doula about using counter pressure and hot and cold compresses on the perineum.

Best wishes to you. You can do this.


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## pantufla (Jun 7, 2007)

Also, I would suggest that you insist on having none, zero, NO vaginal exams. I can't see a VE giving enough information to balance out the pain and inflammation they must cause.


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## nashvillemidwife (Dec 2, 2007)

I'm due in a month and started seeing a pelvic floor physical therapist for the same concerns. It turns out that massaging the upper back has a profound effect on relaxing the pelvic floor. Just a tip for labor.


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