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.

Updates

I'm still working on getting everything straight with the Botox.  My insurance and Dr. Goldstein's office are calling back and forth and it should all be worked out in the next week or so.  Then I'll make the appointment.

I've started on two new drugs for my anxiety and depression.  I'm taking 25 mg of Zoloft once a day and 7.5 mg of Tranxene (1/2 in the morning and 1 whole at night).  I started on the Tranxene doing 1/2 in the morning and 1/2 at night, but now I've gone up a bit.  When I first started taking the drugs I got those bad headaches that I got when I took the Prozac.  The worst of the headaches was about two days after I first started taking Zoloft and they slowly tapered off for about 2 weeks.  I'm happy to say that I am rid of them now.  Otherwise I would not still be taking that drug.  I am actually feeling a lot better - what a relief!  I'm in a better mood, I don't feel so depressed all the time, and I've noticed that I have more patience with my students too.  I'm also sleeping better (and having crazy dreams, which are always fun).  I'm encouraged that I'm finally taking some drugs that seem to be helping;  I just hope they continue to help and don't end up making me crazy like Prozac did.

My husband and I are starting to try and get back to some intimate activities, like a 10 second kiss (sorry if that's too racy for you!) and maybe some massaging and things like that.  Hopefully now that my mental state is in a better place I'll be able to progress in the intimacy part more quickly.  I also want to be able to try sex one I get the Botox because that's really the whole point.  I feel like we are so far from sex, but like my therapist says, I'm not going to want it until I have proof that it doesn't hurt.

It turns out that the AndroGel did do its job.  Apparently I now have too much testosterone and Dr. G wants me to use half the amount I was using for a while.  I'm not sure why I shouldn't just stop using it if my T is too high, but I do what the doctor tells me.  I'm actually a little disappointed that my testosterone is high because I was hoping that it would make me super horny and full of energy - it did not.  It did, however, give me lots of acne.

But I'm feeling more optimistic these days and I hope that the feeling continues.  Being depressed sucks.

You want less wrinkles in your vagina?

It turns out that when you call your insurance company to get approval for vaginal botox injections, it's quite an ordeal.  I was told at Dr. G's office that if I get the botox myself and bring it in that it would be a lot less expensive than having it provided by the doctor's office.  So I had to call my insurance to both find out the approval process for getting the injections and also find out how to acquire some Botox.  First of all, it's kind of awkward to talk to strangers about how you need botox injections in your vagina.  I talked to three people and it seemed that the idea of this was new to all of them.  So first I called the main 800 number for my insurance.  Good news is that they don't require any type of pre-approval for procedures so I can just get it done and send in the claim.  But getting the Botox is more complicated.  The medical department didn't really know what to do, so they transferred me to the Pharmacy department.  The woman I spoke to in the pharmacy department was really quite perplexed and had no answers so she transferred me to the Mail-Order Pharmacy department.  This person told me that the Botox is covered 100% by my medical plan (!) but that I have to pay a $15 copay to my physician.  When I told him that my physician didn't take insurance, and therefore did not take copays, he was also perplexed.  But he said he'd call the doctor's office and get the prescription and set it in motion.  I'm still not sure when the $15 copay comes in, or if it's relevant at all, but I think I'm on my way to getting some Botox sent to me and making an appointment to have it injected into my vagina.

I was on the phone for a long time today.  But for your info, if you get the Botox from Dr. G it costs $565, so it's definitely worth it to try going through your insurance first (I think mine will be free - but it's a little unclear).  And the procedure costs $560 - close to the typical cost of a visit to Dr. G anyway.

The Botox Decision

Dr. Goldstein has reached a point with me where he's not 100 percent sure of what to do next.  My burning is still around and he normally can eliminate the burning with the estradiol gel.  The next step that he would like to take is Botox injections.  My husband and I are not sure about this for several reasons:

1. Dr. G isn't guaranteeing anything with botox - it's just his best guess as to what might help.

2. And this is the main concern.  Once I get botox, theoretically I should have no pain in the vestibule area for a couple months.  This means that during that time is when my husband and I would really need to get serious about sex and penises inside vaginas.  We are both concerned that the timing with botox might be very important.  What if I get the botox, everything's great physical-wise, but the minute his penis goes inside me I freak out?  I think the fact that I've been very down lately, feeling hopeless, and unhorny and undesireous of sexual acts makes both of us worry that it might be too soon to consider numbing the vagina because maybe the emotions won't be able to take it.  Does that makes sense?

Our therapist made a good point though.  She said that as long as the pain is there, the fear will be there.  And as long as the fear is there, it's highly unlikely that I will get any desire back until it is proven over and over and over again that I can have sex without pain.  She also said, taking sex totally out of the picture, what if getting botox just made the burning go away and nothing else?  Wouldn't it still be worth it?  Well, yeah, I guess so.

This is why we need a therapist.  My husband and I were thinking about it in a sex/no sex way with the botox.  And our ultimate hope in using botox is to be able to have sex pain-free.  But what if we still have sexual issues after the botox (inevitably we will because it won't solve all the mental stuff) but the burning is gone?  I just can't imagine!  It would be so wonderful to not have burning.  I could ride a bike, I could sit for more than an hour, my life would be changed in many very small, but significant ways.

And when I think about it that way, I'm inclined to say yes to Botox.  I mean, how can it hurt?  Will it give me pain free sex?  Who knows.  If it does give me pain free sex will my emotions be able to handle it and will I get my libido back?  Who knows.  Will it cure the burning?  Who knows.  Is it worth a try?  I think so.

Any thoughts?  Anyone with Botox experience?