Ganglion of Impar Block - Please Answer if You See This

[FinalCountdown]

(Mods, please merge this into an existing thread if there is one.)

I'm getting a Ganglion of Impar block in 12 hours (I'm male). Can anyone tell me how much this is going to hurt? I had never even heard of this thing until 2-3 weeks ago, but then I met a young, FEMALE doctor. Ironically, an 84-year-old MALE doctor whom I saw the next week was the 2nd physician in 10 years to mention this - I always figured that if someone ever gave me a diagnosis, they'd either be really young, or really old, and it looks like I was right.

Anyway, I've had over 20 injections, from T11 on down to S1, and several more below the belt line. Some of these have hurt like *hell*, and others have been easy (Botox in my piriformis was shockingly easy).

I prefer to know if this is going to hurt - the doctor almost injected me the first time I saw her, but instead decided to wait a month (which is eternity, as I'm sure you all know). She said, "It's a bit awkward meeting someone, and then immediately having them stick a needle in your butt." Is this true, or was she kidding? They can't go *through* the rectum, can they? That would be septic! Is this done right "above the fissure," so to speak?

Thanks if anyone can lend some context to what I'm about to experience. Boy I hope this works, even though I know it would only work for a few hours (the several times I've gotten relief, I've essentially sat under a tree and just enjoyed being alive; then invariably, I would fall asleep, only to wake up and say to myself, "Damn, it's coming back.").

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As an aside, does anyone have contact info for Dr. Hibner? Is he considered the best for a pudendal entrapment surgery (if it's entrapped, it's probably between the sacrotuberous and sacrospinous ligaments). The contact link on his website didn't work for me, and I found some University of Arizona address and wrote, but never heard anything back. I prefer to go through normal channels, albeit on an urgent basis.

Thank you!

[Violet M]

Haven't had a ganglion impart block myself so I can't say for sure how painful it is but I don't recall people making any remarks about it being particularly painful. Dr. Hunter's website describes it as being not complicated and minimally invasive. http://ainsworthinstitute.com/treatment ... par-block/
But as with any procedure there are always some risks so I would be skeptical if anyone tells you there are 0 risks.
The way I used to think of an upcoming procedure such as a nerve block was that since I was already in serious pain it wouldn't make that much difference to have a quick procedure like that even if it was a little bit painful. According to the image on Dr. Hunter's website, it looks like the needle is placed just above the coccyx.

Regarding Dr. Hibner, we just list his phone number on our website. http://www.pudendalhope.info/node/58#AZ
Last I heard he was only treating women but maybe that has changed? Good luck,

Violet

[FinalCountdown]

Well, the strangest thing happened - very nearly *opposite* to what I expected.

The injection itself was sort of "cringe-ville" - the needle went inside me just inside the fissure (but outside the rectum), so you felt quite vulnerable, and there were times when it was quite uncomfortable, but not for long, and the doctor was nice and gave me squeeze toys, and lots of encouragement - it wasn't so bad.

She also gave me the go-ahead to double my new medication. Then had me wait 20 minutes before leaving. I drove home despondent, thinking that nothing at all had happened - not even relief from lidocaine.

I spent that day hopeful that my next day's appointment might bring some answers.

I went to bed at 11 PM on a hard, carpeted floor, with my legs propped up on a wedge, and lied on my back.

At 2 AM (as usual), I awoke, and was quite pleased that, for whatever reason, I wasn't in agony - I took an Ambien only, and fell back asleep on my back. At 6 AM, I woke up after sleeping 7 hours - I felt rested, calm, focused, and most importantly - virtually PAIN FREE for the first time ... this year? in a couple of years? in a few years? ... I took no pain medicine at all, which is amazing. I had an 8:30 AM appointment with a vascular specialist who had his assistant give me a scrotal sonogram, and then write me a script for a CT-Venogram to look for Pelvic Congestion Syndrome. On the way home, (around 10:45 AM), I stopped and helped a man who blew out a tire. My pain level was so low that I didn't even take my medicine with me on this excursion, which hasn't happened to me in years - I almost went to the gym, but decided to have a bit of lunch first and go later. Then, around 11:15 AM, I was sitting on the couch, and was like ... uh oh ... it's coming back ... a slight burning in the perineum, which was faint at first, but getting louder - I tried to make it until noon without an opioid, and didn't. However, this is the first time in YEARS that I'd made it 12 hours with no opioids. Was this delayed onset lidocaine? Is it because I increased medication? Was it because I slept on my back on the floor with my legs up? It's now 2 AM, 14 hours later, and although today has been tolerable, it has still been "one of those days" after 12 PM. We'll see how I feel tomorrow. One doctor wants me to get an MR-Neurogram with a focus on the pudendal nerve (but we all know my titanium hip will show up as artifact), and then I have this CT-Venogram will identify if I have pelvic congestion syndrome. Right now, I still feel that I have compression between the sacrospinous and sacrotuberous ligaments - but that won't show up on either test, will it?

I guess the steroid phase of the test won't kick in until about now, but that won't do anything, will it? I can't imagine. So here I am, back to baseline, after what i assume is delayed-onset lidocaine.

Ugh, what to do ... where to go ... who should I contact? How do I prove I have entrapment, and whom do I call? Dr. Hibner won't operate on males? Why not? My answer won't be found in a bottle of opioids.

[Violet M]

You had a ganglion impar block, not a pudendal nerve block, right? It seems like you need a follow-up appointment for the physician to discuss the results with you. I'm not sure entirely what it means that the relief was a little delayed but hopefully when the steroid kicks in you will have even more pain relief. Pain relief after a ganglion impar block would not be diagnostic for pudendal nerve entrapment though.

Violet