Wrong fit?

[Male Bicyclist]

I saw Dr. Conway about 6 months after the on-set of my pelvic pain condition. It was very frustrating trying to get an appointment, as he won't let you schedule an appointment until he speaks with you over the phone, but he also won't schedule a time to speak with you, and he only tries to call sporadically. I think it was several months before I actually spoke with him and was able to schedule an appointment. It would be nice if his staff did the screening call instead, as waiting several months to schedule an appointment when you are in chronic pain is very difficult. Just to have the screening call earlier would relieve a lot of stress (which, in turn, may relieve some pain).

Once I saw Dr. Conway, I thought that he was very helpful, respectful and empathetic. He took a complete history of the condition, did a physical exam, and spent a lot of time with me. He did not think that I had an actual nerve entrapment, which proved correct as I have had reduced pain with repairing my left inguinal hernia (see discussion below), PT, medication, dry needling, and controlling my numbers of hours of sitting and standing in a stationary position.

One thing that was interesting with Dr. Conway--I had told every other doctor I had seen that my pain came on with the on-set of a left inguinal hernia. Virtually every doctor said that was impossible--I am not saying that they said that they hadn't seen that before, they were certain that an inguinal hernia could have nothing to do with pelvuc pain, notwithstanding the fact that I was completely pain free before the hernia. and had full blown pelvic pain within about a week of noticing the hernia (which was confirmed by my doctor). Every doctor I saw said that there was no sense in getting the hernia repaired, as I should figure out what is causing my pelvic pain first. However, after about 3 months of being in horrible pelvic pain (I was lying around on my side with ice packs in my butt and groin all day, with a TENS unit), I decided to get the hernia repaired, in part on the advice of my pelvic pain PT who was one of the only medical professionals (before Dr. Conway) who thought the two could be related. It was only after I got the hernia repaired that I started to experience a reduction in pain, although the process of getting back to almost normal (I am still limited in how long I can sit and stand) took 4 - 5 years. I mention this as a digression because I think it shows two things--1. most doctors have no experience with pelvic pain. I can only conclude that the vast majority of patients with an inguinal hernia do not exhibit pelvic pain (and, somehow, in the way doctors think, this means that none do).2. Doctors have a funny way of going through a decision tree. Even if they have never seen the inguinal hernia/pelvic pain connection before, you would think that, if a patient has never, ever, had a chronic pain condition, now he has pelvic pain, there is no triggering event to explain it that falls within the physician's experience, but the patient has an inguinal hernial (it is in the pelvic region after all, and everybody who has ever observed any physical system can understand how a tear in one place can affect stability in the whole region), it might be worth at least a quick google search to see if any one else has reported this connnection. (I did the search, and, yes, the connection has been reported). (I know I describe myself as a male bicyclist, but I really think that my bicycling history is a red herring in my case. First, I really don't bicycle that much--I mainly bicycle to do errands and go to work, perhaps 6 miles and an hour a day. I am back to bicycling again with no problems with it causing pain, although I do use a special seat called the Spongy Wonder (you can buy it on the internet) that keeps any pressure off my perineum.)

Although Dr. Conway is a surgeon, he did not suggest surgery for me, but was happy to communicate with my other doctors to suggest a way forward. He really did think about my condition, and spent the time to write down his analysis. Also, once I saw him, he was very responsive in getting back to me.

In short, I think it is a good idea to see him and get his ideas. On the other hand, pain is exacerbated by stress, and having a doctor who you do not feel comfortable with can make things worse, so, if for some reason he is not a good fit, it might make sense to find someone else for your long-term treatment. Although there are few doctors who treat pelvic pain, you do have choices, and you should look around until you feel comfortable with the one you are using.