Health Organization for Pudendal Education

Just returned from botox injections with Dr. Hibner and thought I would update everyone on some new stuff he is doing and future plans.

1) Botox to the anal sphincter: He has only done a handful of these. He injects 10 IU of botox into a couple of sites in the anal sphincter. One patient had some short term incontinence issues. The other patients are doing quite well with it. One patient he said looks like a new woman and said she feels great now that he injected her sphincter. Since he has only done a handful he is still figuring out the best dose and how many places to inject. '

2) Botox to the piriformis: The injection is done under Ultrasound so they know for sure that they are injecting the piriformis muscle and not to get the sciatic nerve. I wish I had known in advanced that he was injecting the piriformis muscle as he would have done it with my pelvic floor and anal sphincter injection but he didn't have the US machine scheduled nor the tech. Next time I have botox with him he'll do the piriformis.

3) Ketamine after surgery: Most of his patients are now kept on Ketamine for 24 hours after their surgery. The hospital has taken a hit on many of Dr. Hibner's patients who had Ketamine and the insurance didn't pay. I would be one of them that the hospital "ate" the Ketamine bill. He will have anesthesia give Ketamine during the botox injections because it is done under general but he can not keep anyone for 1-2 day Ketamine infusions after botox. Dr. HIbner and Dr. Sparlin are working with hospital administration to get the insurance companies to pay for 5-day inpatient Ketamine infusions. It is a work in progress and he doesn't know how long it will take to get insurance approvals as they need to submit to the individual insurance companies.

4) He was recently at Mayo Clinic and practiced dorsal, perineal and rectal branch dissections on cadavers. He still has not done any dorsal decompression surgeries but said he feels quite comfortable in doing the surgery esp. now that he did the cadaver dissections a few weeks ago.

I think that is everything.

NYT,
Thanks for your diligent update, and how are you feeling after your injections? Did you know you were getting botox before seeing him?

Anyone know why insurance is so picky about ketamine treatments? Is this very risky?
I would think if it helps get people out of their chronic pain state, that equates to less doc visits, and less drugs.

Take care,
Debbie

Thanks for the update NYT! Even though botox made me worse, I always appreciate Dr. Hibner's drive to learn and try new techniques for his patients. I wish there were more doctors out there like him! Hope this round of botox helps you greatly!

Thanks nyt,
It's great to see that things are evolving, that can only be good news for all of us. I have always been so impressed with what I hear about Dr. Hibner, he is really interested and forward thinking with pelvic problems. I am glad that he is doing piriformis injections too now, as a few people seem to be finding entrapment problems further up, in that area.
Do you think he is doing the p muscle because of any spasms arising from PN (and lower compressions) or because he is trying to deduce if the p muscle is the culprit for PN? Probably both?
Thanks for the update, take care,
Helen

Thanks nyt for the update on Dr Hibners protocol,
Having met Dr Hibner in Nantes many years ago he impressed me greatly, my only regret was that he observed my case history and told me that he would not have treated me as my Gynae had done in Ireland!
Im so impressed with his useage of medical interventions to try to gain some help in the pudendal pain areas. This is one impressive doctor and he is dynamic in his approach.....if I could travel to see him I would!