I've Been Botoxed

Yesterday was the big injection day.  I wasn't very nervous leading up to it.  I only really got nervous when I was laying on the table with my legs spread and looking at needles.  The idea of having someone put needles into your vagina is quite frightening.



The bigger hole is the vagina and the smaller
hole is the anus.

 First Dr. Goldstein did a short exam to pinpoint the muscles that were the most tense.  I had 100 units of Botox and he decided to split it like this: 50 units in the Puborectalis (6 on the pelvic clock) and 25 each in the left and right Pubococcygeus (around 4 and 8 on the pelvic clock).  My 6 o'clock muscle was definitely the most tender, which is why he put 50 units in that muscle.

As for the procedure itself, I'm not gonna lie.  It was painful.  Fortunately it was a very short-lived pain.  I was afraid of the pricking of the needle, but I actually hardly felt that.  The pain came when he injected the Botox into my muscles.  It felt like fire was spreading through my vagina and all the way to my anus.  It was intense, but it only lasted a couple minutes.  Within 5 minutes I only felt a slight soreness and no fire, so all in all, not bad if you can deal with a couple minutes of fire.  He told me to squeeze and release those muscles at least 100 times that day to make sure the Botox got spread around the muscles.  Now we just wait to see what happens - I'm supposed to do aggressive PT and see if it made a difference.

A side note: while we were sitting in Dr. G's office after the procedure he mentioned that my therapist is the best patient advocate he has ever encountered.  He actually said, "She's a pain in my ass, but that's not necessarily a bad thing."  She will call him until she gets a response and she demands answers.  My husband and I feel very lucky to have her in our corner and we agreed that we love that she is a pain in our doctors' asses.  Dr. Goldstein referred to her as our quaterback.  Now I do know that the quarterback is a very important position on the football field, but that's where my understanding of this metaphor ends.  However I'm sure my husband appreciated the sports reference.  I'll have to get him to explain to me exactly why our therapist is the quarterback.  And now I'm wondering what position our other doctors play.  Is Dr. G the tight end?  Our PT the kicker?

So getting the Botox was pretty much a positive experience.  I had intense pain for a couple minutes, but it subsided quickly.  I just hope it helps.

I can't think of a good title...

It's been over a month since I've written here.  I've had plenty to write about, but I just haven't had the energy to do it.  I've been feeling pretty down lately.  My vagina started burning again after I was doing so well, which has been really discouraging.  I've regressed not only physically, but mentally.  We were making progress with kissing and naked cuddling and it's like a switch went off in my brain and I have no desire to do any of those things.

My job is very stressful and getting worse.  I teach in an inner-city middle school and my students this year are just crazy.  Every day I have to deal with kids screaming, running around the room, throwing things at each other, cussing each other out, having "shut up" fights (they tell each other to shut up and it keeps going back and forth and getting louder and louder).  I leave work every day just completely drained.  They say that your first year of teaching is the hardest, but that is not the case for me.  This is my third year and it's definitely been the hardest.

So after an exhausting day at work, then I'm supposed to go home and do my dilator exercises and do my stretching and cook dinner and get ready for the next day and somehow find the desire to make out with my husband.  It's all just too much.  And it kills me that making out with my husband isn't a stress reliever, isn't something that I want to do but is just another thing I have to cross off my list.

With all that said, I saw Dr. Goldstein again yesterday.  I still have burning, which is why I made the appointment, but that's not all.  It turns out from my hormone test that the testosterone cream basically did nothing.  My testosterone hasn't really gone up at all even though I went through 2 prescriptions-worth of it.  That is both discouraging and perhaps a good thing.  It's discouraging that my body didn't absorb any of it like it should have. However, that means that maybe there's still a chance of my energy and libido increasing when I finally do get my testosterone where it should be.  This time Dr. G prescribed the stuff that men use - Andro Gel (it's the stuff that cyclists use to get better/faster and then get in trouble with the Tour de France).  So it's stronger and hopefully it will work.  I guess if I start growing chest hair and my voice gets deeper we'll know it's working.

Another disheartening thing we found at the doctor was that my pelvic floor muscles are worse.  Now that is partially because of all the burning - I haven't been doing my dilators like I should.  Now my muscles from 3-9 on the pelvic clock are very tight.  He also said that it's only the artificial muscles close to the opening, not the deeper muscles.  So he wants me back on the Valium suppositories (I felt nothing with these, but he still thinks they might help with PT) and he wants me to be more aggressive with my PT and just push through it if it's burning.  He also mentioned that I could get Botox injections to help speed up PT.  We are going to consider it.  It is expensive, but not so expensive that we won't do it.  But I think we're going to see how this other stuff works first before doing the Botox.

I am also still sensitive right where my urethra is.  Dr G thinks I might have a mild case of Interstitial Cystitis.  He said there is a medication for it, but that he is hesitant to prescribe it because the side effect is depression (and I don't need any more of that).  So I have decided that I am going to try a bladder-friendly diet for a few weeks and see if that makes a difference.  It will be hard because I can't drink green tea or eat chocolate or bananas (the tea and bananas are a daily thing for me and the chocolate is not far behind!).  But I'm going to try it and eventually I can work those foods back in one at a time and if they don't bother me I can continue eating them.  Since we aren't sure about whether I have Interstitial Cystitis and if I do have it, it's a mild case, I figure I should try changing my diet before taking medications or doing other more expensive and invasive treatments.

With all the physical issues I have nothing worries me more than the mental stuff.  I still feel hopeful that we can fix the physical stuff,  but I'm terrified that I will never feel horny again.  I'm terrified that I will never feel like a normal person feels.  My husband described it as Post Traumatic Stress Disorder the other day and I think that's a pretty good way to describe it.  It's like anything remotely to do with sex (like kissing) just makes me automatically put up a road block and want nothing to do with it.

I know I can loosen up my pelvic muscles, I know I can get rid of this burning, but can I ever convince myself that I want to have sex?

Test Results Are In

I've had lots of tests in the last month and have neglected to update you on their results.

I mentioned that I was going to see my regular doctor to be tested for hypothyroidism because I have so many of the symptoms.  Well, I have no thyroid issues.  So that's good.  I mean, in one way it would help explain my fatigue, but I suppose I'd rather not have a thyroid issue that has to be treated for the rest of my life.  She also tested me for the Epstein Barr virus that I had when I was younger (due to getting Mono when I was 2) and caused my Chronic Fatigue, and the test showed that the EBV is no longer active in my system.  I'm not sure what this means exactly, because I'm still tired, but I no longer have an active EBV in my body.  Yay?

So why am I still tired?  Good question.  No answer really.  My doctor told me that that might just be my life; that it might be my normal.  Well, I told her that was unacceptable - it's not okay for me to be this tired all the time.  She said the normal stuff - some people need 9 hours of sleep a night (me included) and I try, but it's hard to get that much sleep when I have to wake up at 5:30am.  She also said I need to exercise.  Well, as I've said here before and I said to her, how can I exercise when I'm totally exhausted?  It's a never-ending cycle.  But whatever.  Hopefully the other things I'm doing will help with the fatigue.

My hormone results are back and they are still low.  Dr. G wants me to use a systemic testosterone cream for 3 weeks every day and then 3 times per week until I don't know.  Even though my estrogen is still low, he says I'm out of the menopause low and he wants me to stop the Estradiol for now.  I think he's hoping that my own body will pick up the pace after getting a jump start.  He also prescribed the Diazapam suppositories to help relax my pelvic floor muscles.  I will be getting those today so I'll let you know how they go.  I guess I'll do them anally like he recommended because my vagina is so sensitive - but I'm not looking forward to it!  He can't explain the burning that has returned, but he's hoping that the suppositories will help and I've been trying to do more yoga which seems to help too.  I really think that stretching is key - it does make a difference.

My psychiatrist has lowered my Clonazapam to .5mg in the morning and .5mg at night and added 10mg of Prozac in the morning.  We'll see.  This will supposedly help with the fatigue, but it takes longer to get into the system.  I've been taking the Prozac for about 1.5 weeks and I'm still tired, but he said it could take a month.  It also has some scary side effects, but so far all I've noticed is dry mouth.  If it gives me more energy, I'll take dry mouth.

So the Prozac and testosterone are both supposed to help me in the energy department.  I sure hope so.  I'm so tired.  I want to exercise, but I have no energy.  I'm hoping for the best with these drugs.  We'll see how it goes.

Goldstein Visit #3

Well, I don't even know where to start.  There is a lot of information to share.  It helps me to break it into categories so that's what I'll do:

The Vestibule:

It appears that my vestibule is pretty well healed.  I didn't really have much pain with the Q-tip test, so that's good news.  Dr. G said he may take me off of the Estradiol, but he wants to learn the results of my hormone test beforehand.  I would be shocked if my estrogen is where is should be, but according to my vagina - Dr. G thinks I have some good estrogen down there.

Hormones:

I'll get the results back next week, but like I said, I just don't think there's any way my hormones are where they should be.  Dr. G did prescribe Testosterone gel that I am supposed to apply daily to my legs.  He also said that I should rotate the spot of application because it can make me hairy!  (yikes!)  He said it also might cause more acne.  But he also said that it could help with my libido and give me more energy, so that is a trade I'm willing to make.  Depending on the results of my thyroid test, we might just stick with the testosterone gel for now before trying other methods to increase my energy.  He said he doesn't want me trying too many new things at once - and I agree.   

The new (or is it?) problem:
Lately during PT, I've been feeling pain at the 12 o'clock spot, but not in the pelvic muscles - it's actually where my urethra is.  I told Dr. G about this and he went in there, and it was, in fact, quite painful.  He's not sure what to do about this, but he mentioned seeing a urologist (great, another doctor).  However, like I said earlier, he doesn't want me doing too many new things at once, so the urologist idea is tabled for the moment.  This problem actually made Dr. G question himself - he said "is this new or did I miss it the last time?".  I don't know the answer to that question either.  Maybe it was there, but the other problems were more prominent.  I don't know.  But it's definitely there now.


The burning is back:
My vagina has been burning on and off for about the last two weeks.  Dr. G actually has no answer!  He says from a visual standpoint, everything looks burn-free.  He actually admitted that he wasn't sure what to do about that.  In a way, I'm disappointed that he didn't have a solution for me, but it also makes me trust him more.  It's hard to trust someone who thinks he knows everything, and now Dr. G has proven that he doesn't think that - that there are things he doesn't know.  And to me, that makes him a better doctor.  With that said, I hope he/we can figure out what all the burning is about.


The discharge:
I told Dr. G how I've been having rivers of discharge for the last three weeks and he said, "yes!  Your ovaries are working!".  Apparently, normal women have a lot of discharge and it's nothing to worry about (however it is quite bothersome).  But it made him very hopeful that my estrogen levels have risen because now my ovaries are doing their job.  In his words, "most women are dry as the Sahara because they are taking birth control.  This is not normal".  So okay, my leaky vagina is normal.  Yes! One point for me!  I used the word normal in the same sentence as vagina!

Estradiol info:
I found out exactly what the base was in my new Estradiol gel - it's Acid Mantlebase - Dr. G says that it can be less irritating for some people because it has lipids to hold in moisture and act as a barrier and that it has an emollient affect.  My original Estradiol base was Methyl Cellulose, which is basically water, which is why he usually prescribes it because it tends to be less irritating, but I needed something more.

Anxiety Meds:
I plan to talk to my psych about changing from Clonazepam to something else because I'm just too tired.  Dr. G said that meds like Prozac and the like do have a libido side effects, but that it would be okay to try them for now if I need to get my anxiety down.  He also wants to consider a Diazapam suppository, which is basically Valium to help relax my pelvic floor.  But we're waiting on that as well.  Not too much at once.  He said anal suppository and I was like, "what what?!  You want me to put it in my butt?"  I do not want to put things in my butt.  But he said that he usually says to put it in the vagina, but since mine is so sensitive he worries that there will be a negative reaction.  So, I might have to put a suppository up my butt.  I'll do it, but I won't like it.  However, if it helps, I'll like the result.

Well, I think that's all.  We really did a lot yesterday and my brain was so fried I couldn't write this entry last night.  So I'm writing it now at work instead of doing work :).  Please ask any questions.  It's a lot of information.

Well, the ball is rolling, but probably not fast

I went to the doctor yesterday to get tested for hypothyroidism, among other fatigue-causing illnesses.  She doesn't seem to think that I have it, and I probably don't, but we did blood work, which I will get back next week.  If it's not that, then we'll just start a guessing game I suppose.  I just want to be normal, and you all may not know this because this blog is about my vagina, but I've been tired my whole life - more tired than other people.  I go to bed by 9pm at the latest every night and I'm still exhausted.  I was diagnosed with Chronic Fatigue Syndrome when I was a teenager, but knowing that really doesn't help me be less tired.  All they say is "get more sleep".  Okay, well if I go to bed any earlier, I won't be able to fall asleep, plus I won't get anything done!  It's frustrating.  Hopefully we'll figure out something eventually.  More sleep is not going to help - I already get as much sleep as I can and I'm still tired.

I'm going to see Goldstein tomorrow so I'll post an update soon about that.

Which Estradiol Gel?

Well who knew there were so many choices?

Dr. Goldstein prescribed Estradiol gel to me in April.  As I've said before, the gel at first was very irritating. Over time I got used to it more, but it still irritated me sometimes.  At this point my gel was 0.03% estradiol and 0.1% testosterone in a cellulose base.  I started reading on other blogs and on my vaginismus yahoo group that some people have Estradiol gel with an Emu oil base.  I called Dr. G. to find out more about this. His office called their pharmacy and the pharmacist explained that many people find the emu oil to be more soothing, but not necessarily for the right reasons.  It turns out that the emu oil absorbs more of the estrogen and testosterone, making less of it actually absorb into your skin, making it less irritating because it's the hormones that are irritating in the first place.  So I didn't want to go with emu oil because I want as many hormones as possible getting into my body.  They did have one other suggestion - to use the same ratio of estrogen and testosterone in a different base - I wish I could tell you exactly what the base is, but on the bottle all it says is "ACID MA# 100".  I have no idea what that means exactly, but the word "acid" sure is scary.  However, I do like this version better.  It is less irritating and thicker.  I still get irritated sometimes, but it's less than with the cellulose-based Estradiol.

So there's the rundown on Estradiol options.   Please let me know if you have any questions.  When I go see Dr. G. on October 21, I'll find out exactly what that "acid" base is.

Making Progress

I had my three month follow-up appointment with Dr. Goldstein yesterday.  It went very well.  Before I tell you what happened in the appointment I'll tell you the changes that I have personally noticed since starting the Estradiol:

-the overall burning problem has all but disappeared.  I occasionally have it, but that's a drastic difference from feeling the burning almost all the time.

-Sitting for long periods of time does not make my vagina burn (there's still a bit of discomfort, but no burning) - I recently went to Italy and the 9 hour plane rides did not cause burning.  :)

-My vagina feels more moist in general - it's not a "I'm turned on and my vagina is moist" thing, it's just a general moistness.

So when I had my feet up in the stirrups (they were animal print and furry this time, by the way, and quite comfy) the first thing Dr. G. said was that my vagina visually looked better.  He could tell just from looking at it that the tissue was healing. 

Then he did the Q-tip test.  In almost all the places that I had originally given a grade of 7 out of 10 on the pain scale had NO PAIN AT ALL when he touched them with the q-tip.  There was one area that is still sensitive and I know why, because I haven't been putting the estradiol there when it turns out I should have been.  But this is really something.  I mean, 3 months ago that q-tip made me cringe in pain and yesterday, other than that one spot, there was zero pain.  He also tested my muscles and even they were improved even though I haven't been doing PT in the last 3 months.  However, it makes perfect sense that when there's less pain, the muscles won't involuntarily clench as much.

They took blood in order to check my hormone status now.  I have a feeling that it may be higher, but still not as high as it should be.  In Dr. G's words, I did have the hormones of a 45 year old menopausal woman, so I'm hoping to at least be down to a 40 year old pre-menopausal woman at this point (I'm 27 in reality).  Dr. G. asked me if I've been feeling any more desire or even had any sexy dreams or anything like that.  Unfortunately, no.  However last night I had one of those naked in public dreams, does that count?

Dr. G. still doesn't seem like he thinks that there is any need for me to be on anxiety meds, but he said he was okay with it.  So I will continue to take those and see if they can just give me the nudge I need to break through my sexual fear.

So I'm supposed to continue using the Estradiol, especially in the spot that I've been missing, and I'm also supposed to start back with PT to get those muscles where they should be.  I feel very encouraged and hopeful about all the physical stuff.

And I continue to hope that once the physical stuff is solved, the mental stuff will start loosening up too.

The big appointment.

Well, after many months of anticipation, my appointment with Dr. Goldstein has come and gone. I have a lot to say, so hopefully this post will not drone on for too long and make you lose interest.

Obviously this is a big deal. After so many years of half-assed treatments or no treatments at all, after a year and half of physical therapy, which has helped but not completely solved the problem, deciding to go see Dr. Goldstein was a big decision (not to mention an expensive one too). I tend not to get too nervous about things ahead of time, but instead reserve all my nervousness for the day of, at which time I get sick to my stomach and just want to lay down I'm so nervous. It wasn't any different this time. I woke up on Tuesday just feeling nauseous. I know it's just a doctor's appointment, but you know, it's hard. It's hard to talk about, especially to someone new, having to explain the whole situation over again. And I also felt some anxiety about what would he say, would he know what's wrong with me, would he be the big jerk that I've read from other people online? So I was nervous.

Let me mention now that on Sunday I went to the bathroom and low and behold, the toilet paper was pink. Great. My period started a week early two days before my huge vagina appointment. I freaked out. I didn't know if the doctor would even still see me or not. I know that doctors aren't bothered by it, but I wasn't sure if this type of appointment needed a blood-free vagina. However, I called and they said it was fine. But man, worst timing ever right? I felt like crap, I had cramps, and I was really tired. Great way to go into my appointment.

So on to the appointment. Basically the appointment was broken into three segments: consultation, exam, consultation.

Pre-exam consultation: We went into Dr. Goldstein's office and started going over the paperwork that we had filled out prior to coming, about my history and my symptoms. Dr. G asked many detailed questions and was very thorough. I thought that we were prepared, but he asked some questions that I really couldn't answer. Like did they look under the microscope when I was being diagnosed for all those yeast infections during college? I'm really not sure. What were the names of all the yeast medications I took? Again, really no idea. When you're in college and you have a yeast infection, the last thing you're thinking is, "I better write this down because in a few years I'm gonna need to know what I took when I inevitably end up at the vagina doctor".

But all in all, the conversation was relatively painless. Don't get me wrong, any time I have to talk about this stuff it's hard and I cry. But it wasn't too bad. And despite the many negative reviews I've read of Dr. G, he was compassionate, straightforward, and nice. He is as arrogant as they come, there's no denying it, but he wasn't rude nor was he a bully, like I feared he might be. He does, however, think that most doctors are complete idiots, which he never specifically said, but it was clear that he thought so. The only thing he really wasn't open to was my psychologist's recommendation that I start taking anti-anxiety medicine. He felt that since I don't have anxiety in my normal life and I only have it related to this subject, that it really wasn't necessary. We'll see how my therapist feels about this.

The exam: The fun part. Well, the first thing I saw when I walked into the room was a camera and a big computer screen and I thought, oh lord, I'm going to have to look at my vagina on that screen. I was right. My vagina was triple sized and we had live action shots of the whole exam. As you can imagine, I was not super excited about this. No one wants to see their vagina on screen. But I have to say, once I got over the initial humiliation of sitting in a room where four people (me, Dr. G, my husband, and nurse) were looking at my vagina on screen, it was actually quite interesting and informative. He very thoroughly touched each part of my vagina with a cotton swab and asked me questions about how it felt and the level of pain. He showed me the different parts of the vagina and explained them.

Then he sprayed my vagina with vinegar. Yes, you read that right. He sprayed my vagina with vinegar! Never in a million years did I ever think that one thing he might do is spray my vagina with the main ingredient in Italian dressing. He did this to check for skin problems - I guess the vinegar makes them show up or something. But I have to say, that vinegar stung like hell. It was like my vagina was on fire. But fortunately it was only for a couple minutes and then he rinsed it with water. Both Dr. G and the nurse said that it was hard to read me because even when I was describing my pain as a 7 out of 10 I really didn't react in an outward way. They called me stoic. I can tell you that I am an expert at stoic. How do you think I had painful sex with my husband for so long without him knowing just how horrible it felt?

Again, during the exam, Dr. G was very sensitive and supportive. He wasn't a jerk and he didn't make inappropriate jokes (another thing I read somewhere else). His nurse was also very supportive. I can tell that her job is basically to make the patient feel as comfortable as possible. I had my husband there with me for support, but that nurse made me feel like if he wasn't there, she would have given the support I needed. She was there right next to me the whole time, she had her hand on my arm and she was very encouraging, both in what she said and how she acted.

Post-exam consultation: A huge difference between this appointment and most doctor appointments that I've had in my life is that there was absolutely no time constraint. We never once felt like we were being rushed and Dr G took time to explain everything thoroughly. At this point, Dr G was ready to give his diagnosis. So here it is, drum role: I have Vestibulodynia! Dr G then went on to say that this really isn't a diagnosis because it's just like saying I have knee pain. The word dynia means pain in Greek, so vestibulodynia means that I have pain in the vestibule (see diagram to find out where the vestibule is). Makes sense. But he went on to tell me what he believes are the causes of this pain. He believes that there are two:

1)Atrophy of the vestibule tissue - most likely caused by the use of birth control pills. As he explained, birth control pills intentionally lower your estrogen and testosterone, but this can have very negative effects on your vagina (it effects everyone differently so it's basically just a coin toss). The vestibule needs these hormones and without them it goes into atrophy, which causes pain. He has prescribed a gel that he wants me to apply to the area for 3-6 months.

2)Pelvic floor dysfunction - tight muscles. This is what I've been working on at PT and I already know a lot about. But Dr G believes that the reason that PT has only worked up to a point is that I really need to treat the atrophy first before treating the muscles, or else a lot of that muscle work will be useless. This makes a lot of sense because my muscles have made great strides over the past 1.5 years, but I'm still not better. So he recommends that I treat the atrophy first with the gel and then in about 3 months start back up with aggressive PT when my vagina is more ready to receive it. He says that I should be able to have pain-free sex by the end of this year. Then he said, "I know that's a long time..." and both my husband and I were like, "dude, it's been years. If you're right, a few more months is really insignificant."

So there it is. There is more to say, but honestly, this post is getting too long, and I hate reading super long posts. My final thoughts are these: Everyone has different experiences and I certainly don't want to discount the women who said that Dr. Goldstein was horrible. Maybe he was horrible to them, but that was not my experience. For me he was empathetic and supportive and my overall feeling when I left there was a positive one. However, I'm not quite ready to shout his name from the rooftops yet either. I have my diagnosis and I have a plan of attack. I'm not going to say how super-awesome he is until that plan works. When I am having mind-blowing and pain-free sex with my husband, then I'll start singing Dr. Goldstein's praises. Not at the same time. First I will have earth-shattering sex, and then later, when my clothes are back on, I will praise Dr. Golstein! Until then, I will continue working really hard and doing whatever I can to heal my vagina.

Phew!

It should be easier.

So if you've been reading my blog you know that I have an appointment to see Dr. Goldstein, but from all the negative things I've been hearing, I've been trying to get an appointment with Dr. Kellogg-Spadt instead.   Well, easier said than done.

I called 3 weeks ago to try to make an appointment and ask some questions like how does the 1st appt. typically go, how much does it cost, etc.  The woman that I spoke to wouldn't even hear my questions.  She said they won't do anything until they see my insurance card.  So my husband faxed my insurance card to them the next day.

Waiting.  Waiting.

Waiting.

Finally my husband called them the next week after we hadn't heard back from them.  Here's how the conversation went:
"Hi, I faxed my wife's insurance information last week and ..."
"Yeah we got it, we'll call you tomorrow, can't help you today."
"Okay...."

Notice how he never even said my name or his name, but she chose to cut him off and said that she did get my info and would call the next day.

Next day - nothing.

My husband called them back the day after that and it turns out they never got the fax.  Interesting.  So he faxed it again.

Waiting.

Waiting.

Waiting.

Finally I called them the next week and the woman I spoke to said, "Yes we got your info but we haven't looked into it yet.  I'll call you back."  I think she could hear the annoyance in my voice so I think she got right on it and called me back a few hours later.  It turns out that they do not accept my insurance (not their fault, my insurance sucks) and it would cost anywhere between $1,000-$3,000 for the first appointment.  I said I wanted to make an appointment anyway.  Of course I would love for my insurance to cover it; I'm far from rich, but ultimately I'm going to pay the money no matter what.  If that was the only problem, there'd be no problem.  This is a priority.

So as she was getting my information, she found out that I live in VA.  She said that it would be better to set up a phone consultation.  I said no, but what I really wanted to say was, "only if the doctor can examine my vagina through the phone.  Otherwise a phone consultation is pretty useless".  She asked me how I expected to have a doctor that is so many hours away.  I told her that I thought I could go to Dr. Kellogg to get a diagnosis and then do maintenance and follow-up treatments with my own doctor (and a few follow-ups with Dr. Kellogg as well).

No.

She said that I would be expected to go to Dr. Kellogg at least once a week for who knows how long and maybe I should look for a doctor in VA that is covered by my insurance.  Really?  I never thought of that!  Well let me just pull out the phone book and look under Vulvovaginal Disorders!  Oh look, there's hundreds of doctors in my area who can tell me what's wrong with my crotch!

Fine.  You win.  I give up.

Dr. Kellogg may be a great doctor, but I guess I'll never know.

So I'm back to going to Dr. Goldstein.  Some people have had good experiences with him, so I'm hoping that I can add myself to that group.  My husband will be with me so that gives me encouragement that he won't let Dr. Goldstein bully me around.

Why does it have to be so hard?

Dr. Andrew Goldstein

I have made an appointment (or should I say, my husband made an appointment because I'm too emotional to get through those kind of things without breaking down) to see Dr. Goldstein in April. He owns the Center for Vulvovaginal Disorders and has offices in D.C., New York, and Annapolis. Has anyone gone to this doctor or heard anything about him?