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Decrease in sexual urges can lead to various untold situation. It brings halt to your normal life and your relation with your partner may proof to be serious and sometimes you may be on a verge of a break up. Sexual dysfunction comprises various disorders like decrease in sexual drive, loose the ability to achieve or maintain a sexual excitement, loose the ability to achieve orgasm or uncontrolled ejaculation. Disorders related to sex lead to anxiety, sexual frustration, and also insomnia. Mainly, sexual disorder relates to erectile problem.
But, remember that every problem has a solution. Levitra is solution to such so called sexual dysfunction. It is a medicine specially formulated to treat erectile problems. Its use has improved the quality of erections in majority of men. FDA have approved it and confirmed it that problems of erectile can be cured at any age. Recent studies confirmed that patients consuming Levitra is experiencing quality erections.
Now, how does Levitra work? It helps increase in blood flow to the penis and keep an erection that last long enough to finish a sexual act. Once a sexual act is over, the blood flow must stop and this what Levitra does. It has been clinically proved that it improve erection quality even for men who have high cholesterol, high blood pressure, or diabetes. A lot of man who tried Levitra for the first time found it to be effective and tried it again. According to them it helps them to maintain their erection for a longer time during intercourse and gives full satisfaction.
It comes in 2.5-mg, 5-mg, 10-mg, and 20-mg tablets and is taken only when needed. A tablet a day is enough to keep you sexually fit. But it’s your doctor who will decide whether you need to have Levitra or not and if needed then what’s the dose. Besides clinical trails have found that the most commonly side effects are headache, flushing, stuffy or runny nose. One thing that should be kept in mind that Levitra doesn’t work in sexually transmitted diseases. So if you are experiencing a lack in your sexual urges, better go to your doctor.
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Courting
There are many different courting behaviours and ‘rituals’ among lizards. Many species bob their heads up and down, and display their dewlaps. Several other species, including agamas and chameleons, move their front leg up and down or in a circular motion. Some lizards are known to bite the other during courtship. Lizards seldom eat while courting, with minimal drinking as well. This is normal and you should not be concerned if the lizards are kept healthy. After mating takes place, the lizards will eat at a slightly accelerated rate.
Mating
All male lizards have a skin flap at the base of their tail, covering what is called the cloaca. The sexual organs are concealed within the cloaca. They have paired organs, called hemipenes. They are within the ventral portion of the tail, covered in sheathes. A vans deferens connects each testicle to one of the hemipenes. The lizard’s testicles are located inside the body.
The vast majority of mammals mount their mate from behind, which is not true of lizards. It is actually impossible for a lizard to mount their partner in this fashion. Male lizards will approach the female from the side, with many biting the neck of the female, and try to get their cloaca in a position as close as possible to the female. At this point, the closest hemipenes is erected. The hemipenes of many species of lizard is adorned with thorns or ‘hooks’ of some kind, securing a hold during mating.
At this point, the sperm will travel through the penis, along the hemipenes’ channel, to the females cloaca. Fertilization occurs when the sperm enters the oviducts of the female. Some species of lizards, as with Veiled Chameleons, can store the sperm for later fertilization without the need of a male.
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I really don’t know how to say this any other way. My dog decided to talk to me the other night and he had a lot to say.
It initially played like any other night really. Once again, I was tossing and turning, in and out of sleep. I was half awake, mulling over my job situation: I want to make money writing but I need an income more. Then the most bizarre thing happened.
“Hey human Bob! This is your best friend speaking! Wake up!”
Who the hell was that? It was a deep, low voice; strong and certain with a hint of a bourbon induced slur. Sounded like Dean Martin actually. I immediately sat up. It was pitch black. The radio clock blurred 3:53 in a dull crimson light. All I could make out was the shadowy outline of Parker, my trusty beagle, sitting upright at my feet.
“Hey boy, did you hear that?” I whispered instinctively. “Someone’s in the house.”
My vision was starting to warm up to the darkness. Parker just stared back at me, his head tilted, his long ears hanging to the side of his head like hand towels on a wall. He turned his head to the bedroom doorway, lifted his nose to the night and sniffed. He turned back to face me.
“Don’t think so.”
I swore Parker spoke but it couldn’t be. I mean his hound drawn lips seemed to move to the words I heard but that was impossible.
“Who’s there?” I yelled into the night. “Whoever it is, I am warning you that I am at this moment retrieving my loaded double-barrel twelve gauge from under the bed. I will shoot you. So leave now and I want to hear the door slam behind you.”
I made some dumb noises in a lame attempt to fool the intruder into believing what I had just proclaimed. I took the ruse to the next level.
“Okay. I’m fully armed and about to call 911 from my fully powered cell phone. Oh yeah, strong signal, four bars. Oh yeah, this is going to be a very clear 911 call.”
“You’re breaking me up. Put the phone down human Bob.”
It was Parker talking. I was certain of it. Nah, it had to be a sick trick.
“Okay, good one Steve. You wired up the dog with a little speaker. Very funny.”
My brother Steve was known to go to great lengths to pull off pranks. But I was pretty sure he was at his apartment in the city, sixty miles away, God knows doing what, and at 48 years old, unlikely to suddenly bother me with a prank—it had been 25 years since his last one. But the mind scrambles to the most implausible scenarios when so duly challenged.
“Don’t think so. Nope it’s me, Parker,” the dog mumbled.
I was positive he spoke again. By now I was sitting straight up, leaning towards him. He just sat there and looked at me with those big dark eyes. His poker face was on.
“Parker? Are you talking to me?”
“Well I’m not talking to myself.”
I leaned back against the headboard. He yawned.
“This can’t be. I’ve got to stop watching Animal Planet.”
“Listen, I’ve got something to say and I’m not sure how long this talking stuff is going to work so …”
“You are talking!” I interrupted incredulously.
“Should you want I bow wow?”
“Holy cow! Parker you are talking.”
“Yup. But I’m not sure for how long. So can I say a few things before …”
“I can’t believe this.”
“Yeah I know. Either can I but if you don’t mind.”
I looked at him with a giant smile plastered across my face. Parker can talk. The dog was talking. Who was I kidding? It had to be a prank. He continued.
“I’ve been listening to a lot of that talk radio and that C-SPAN channel you watch while you write. I’m here to tell ya I don’t like what I’m hearing.”
“You’re kidding me right?”
“Afraid not.”
Oh this was good. I was really hallucinating. Talk-shmalk, I had a few nagging questions of my own.
“Hey, can I ask you something before you get to your stuff?”
“Make it quick. I haven’t got all night.”
“You like smell things a hundred times more than we do, right?”
“Four hundred.”
“Okay, four hundred. Wow! Then I really wonder about this.”
“Yeah I know. Why do we like to sniff every morsel of excrement or yellow patch of urine we encounter on our walks?”
“Now that you bring it up, yeah, why? It must smell like the inside of Dick Cheney’s or Ted Kennedy’s septic tank? And you know how much crap they’re filled with.”
“That was a funny one human Bob. But it isn’t like what you smell. We pick up a lot more notes. It’s a broader pallet if you will. We don’t smell stink. We smell identity, mood, and illness. For instance, you know that crazy cairn terrier down the street?”
“Yeah.”
“She has stomach cancer and her humans don’t have a clue.”
“You are kidding me?”
“She probably has less than six months if they don’t get her to a vet soon.” He paused to lick his right front paw. “Yeah, and another thing. Don’t take me out at nights for awhile.”
“Why?”
“Cause there is a rabid possum living under the porch. That’s why.”
“You know this from the smell of possum poop?”
“Excrement.”
“Whatever.”
“Yup.” Parker yawned as if bored. “So is that it? Can I say what I need to say?”
“Well there is that thing you do with that licking your, you know, your …”
“Penis?”
“Well, yeah.”
“Jealous are we?”
“Well, it’s just that …”
“It’s all about keeping clean. Nothing pleasurable if that’s what you’re driving at. Nothing like what you do with your hand. By the way, I’d appreciate it if you wouldn’t pet me afterwards. Nope, no pleasure; it’s all business. You made sure of that when you had me “fixed”, remember. Thank you very much.”
“Oh yeah, sorry about that. I had no idea you knew any different.”
“No idea my butt. I’ll ‘no idea’ ya.” He paused again to lick his right paw again and then continued. “But I don’t hold it against you. We don’t hold grudges. Heck, if we did, we would have mauled most humans dead by now. Which brings me to why I am talking to you.”
“No grudges. Really? I mean that “fixing” stuff is pretty serious. That’s pretty good if that doesn’t bother you.”
“You done? Can I get to my concern?”
“Sure. Sorry. Go ahead.”
“How can humans be so smart supposedly, while they single handedly are destroying the Earth?”
“You mean global warming?”
“It’s more than that. It’s the air. It’s the water. It’s the dirt. It’s the forests. It’s the killing. It’s the anger. It’s the hate. It’s the grudges. It’s the fear. It’s everything.”
“Oh come on. You’re being a little dramatic.”
“We don’t know dramatic.”
“Well give me examples of what you mean.”
“First of all, the air is filled with danger. Dogs, cats, birds, animals of all kinds can smell it. It is our biggest topic when we get together.”
“I don’t smell a thing.”
“Yeah, that’s part of the problem. And you can’t taste the troubled water either.”
“Scientists don’t seem to be complaining. So I should be listening to a dog?”
“We have no agenda. Dogs call it as they smell it.”
“ ‘call it as they smell it’; I’m suppose to just accept that?”
“Yeah, there is a lot you should just accept.”
“Oh yeah, like what else?”
“Well, and here is what I think is the crux of the problem, you keep choosing the wrong alpha humans.”
“What?”
“You’ve got this alpha thing all wrong. Just because animals order their packs based on physical size and strength doesn’t make it so for humans. We do it because we are simple. You do it because you are thoughtless. That’s what we, and I think it is fair to say I am speaking for all animals, don’t get. Humans are able to think things through. But they never do. Well, that’s not completely true; some have but they are mocked or marginalized.
An alpha dog barks and gets all puffy, like that wacky shepherd Sarge from around the block. The worst he can do is break out of his electronic fence and charge one of us. But you humans take it up a notch.”
“Can you give me a for instance?”
“God there are so many. Let me see. Okay, you’ve elected a president who pounds his chest and walks around like a gorilla with its arms all out to the side, all tough and all, carrying on with ‘bring it on’. When he jumps the fence, he brings tanks and bombs and humans loaded down in weapons and in body armor. Meanwhile, you have alpha males all over the place, flexing their muscle in their packs, threatening to obtain nuclear weapons, the great equalizer, giving the president one excuse after another to hop the fence. It’s nuts. And I for one am telling you, you’ve got it all wrong.”
“Well, I don’t know what to say.”
“You don’t need to say anything. Just start picking the right alpha humans; humans whose visions see beyond fighting, whose hearts hold no grudges, whose thoughts and reasons are not the products of testosterone, whose collective knowledge is rooted in the concept that true peace is never the consequence of war but the outcome of constant learning, negotiating and adjusting.”
“This is what you want to tell me? Nothin’ for nothin’ but it’s a little heavy for a little chat with a dog at 3:30 in the morning.”
“In a nut shell, yeah.”
It was hard to accept this from my beagle. I mean, he’s a dog; a sleeping, eating, sniffing, crapping dog. I was chalking this whole episode up to stress. I was apparently snapping.
“That’s it. I’m pretty much done. Just one last thing while I have the chance.”
“What? World hunger? String theory?” I asked sarcastically.
“You get the right alpha humans and the world hunger thing will take care of itself, smart ass. As far as string theory, who do you think I am, Hawking? I’m just a dog. No it’s more pedestrian than that, something I think you can manage.”
“Then what, already?” I asked impatiently.
“You know that thing you do occasionally where you empty the dish washer in the buff.”
“Ummm … yeah I guess.”
“Put some clothes on. It’s disturbing. I’m beggin’ ya, please!”
“All right, but only if you lick your privates in private.”
“I’ll see what I can do. No promises.”
“So this is it? No more talking? You know we could make a fortune on Letterman with his stupid pet tricks.”
“It’ll never happen. You see, this is a one time deal. Not sure why or how this is happening. Maybe that God guy is involved somehow. All I know is that when it is done, it is …” He abruptly stopped talking.
“Parker?”
Not a grunt. He yawned and as he did he stretched his front legs out and spread across the foot of the bed, his ears resting flat on the blanket.
“Parker … are you done? Is that it?”
He slowly closed his eyes and floated off to sleep.
“Parker … just like that?”
He began to twitch; in hot pursuit of a fox I imagined.
“Holy smokes. I must be dreaming myself.”
I curled back down under the safety of my covers, scratched my butt and thought about the conversation I had just had with Parker or myself or both. I sniffed the air. It smelled fine to me. What the heck was he talking about, ‘danger in the air’? It had to be a dream.
As I drifted off to sleep, I thought about getting a real job real soon, apparently this writing stuff was getting the best of me. I also made a point to remember to talk to the owners of that crazy cairn terrier. I thought it was the least I could do. One can’t be too dismissive of the unexplainable these days.
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From our deconstruction of hundreds of Hollywood blockbusters at at www.managing-creativity.com
The Hero's Journey is the template upon which the vast majority of successful stories and Hollywood blockbusters are based upon. In fact, ALL of the Hollywood movies we have deconstructed are based on this template.
Understanding this template is a priority for story or screenwriters.
The Hero's Journey:
a) Attempts to tap into unconscious expectations the audience has regarding what a story is and how it should be told.
b) Gives the writer more structural elements than simply three or four acts, plot points, mid point and so on.
c) Interpreted metaphorically, laterally and symbolically, allows an infinite number of varied stories to be created.
and more...
Transamerica (2005) deconstructed
FADE IN: the voice range; this is the voice I want to use.
Meeting the Hero: Bree getting dressed.
Hero in her Ordinary World: walking out of the house; waiting for the bus.
Developing the Hero: the doctor asks questions about her.
Motivation / the Elixir: you can sign that consent form.
Refusing the Elixir: the doctor is resistant.
Hero's Backstory / Foreshadow of the Transformation: my family is dead.
Developing the Hero / Elixir: Bree pushes her penis back.
Devolved State: Bree is a busboy in the restaurant.
Hero's Capabilities / Ordinary World: Bree telemarketing.
Call to Adventure: Toby calls.
Refusal: Bree tries to ignore the call.
Meeting the Mentor: the therapist, Margaret.
Pushed toward the First Threshold: Margaret won't give her permission.
Resisting: he's probably a scam artist.
Time Pressure: I can't delay my operation, the waiting list is a year long.
Preparing for the Journey to the First Threshold: thinking about it in her room.
First Threshold from Afar: outside the police station.
Threshold Guardian: the officer.
Backstory of Hero 2: Toby is into drugs and a prostitute.
Meeting Hero 2: Toby brought out.
Outer Cave: at the restaurant.
Middle Cave: inside Toby's room.
Foreshadow of the Transformation: maybe I'll be a blonde.
Resisting the Inner Cave: Bree calls and lies to Margaret.
Inner Cave: Bree agrees to take Toby home.
Consciously agreeing to the Transformation: Toby refuses the drugs.
Physical Separation: on the road.
Journey to the Belly of the Whale: in the car.
Resisting the Belly of the Whale: Toby doesn't want to go home.
Developing Characters and Relationships: Filling up at the gas station; Toby hides his money.
Developing Characters and Relationships: arriving at a hotel; Toby lying naked.
Resisting the Belly of the Whale: Toby repeats he doesn't want to go home.
Developing Characters and Relationships: waking up in the morning.
Developing Characters and Relationships: driving in the car; talking Lord of the Rings.
Push to the Belly of the Whale: Turning off to Calcun.
Resisting the Belly of the Whale: Toby runs away.
Forced to the Belly of the Whale: Grandma gives Toby a hug.
Developing Characters and Relationships: grandma plucks out Bree's nasal hair.
Pushed to the Belly of the Whale: Bree fetches Toby's step dad.
Belly of the Whale:
Toby and his Dad have a fight; Dad's been abusing him.
Polarization: Bree apologises.
Polarization: Toby camps outside.
Push to the Physical Separation: Grandma tells Bree that Toby's Ma killed herself.
Physical Separation: Toby hitchhiking; Toby getting in the car.
Polarization: in the car; Toby won't talk to Bree; Toby insists on the drugs.
Polarization: in the café; I'm not his mother; sitting on the other side.
Creatures of the World of the Transformation: filling up at the gas station; the men watching.
Trial 1:
Outer Cave: Toby is camping out.
Preparing for the Outer Cave: Bree shopping for camping gear.
Outer Cave: Bree cooking.
Middle Cave: Going to the ladies room; do you think there are snakes around here.
Inner Cave: Toby talking about his dad by the campfire; Bree takes her pills.
Transformation 1:
Waking up; the bright idea; Bree will set him up in the telemarketing field.
In the car; working in a pet store is not very ambitious.
Trial 2:
In the café / store; Toby meets the girl.
The child reads Bree.
Bree phones Margaret.
The girl kisses Toby.
Transformation: (Bree acting as a mother) Bree wants to be introduced to Toby's new friend.
Resisting the Transformation: "..Margaret, I don't think I'm cut out to be a mother…"
Trial 3:
Forced to the Transformation: Bree forced to pray at the table.
Acting like Mother: eat your vegetables; a condition for buying the hat is not to do drugs.
Resisting the Transformation: Toby does drugs.
Transforming: Toby gives Bree the hat.
Celebration: Toby hanging out of the window of the car.
Journey to a (glimpse of ) the New World: why are we going to Dallas?
Warning: I hope you'll be on your best behaviour.
Threshold Guardian: Marianne welcomes them.
Outer Cave:
New World: Bree surprised to be at the Gender Pride meeting.
Initiates: Marianne passes the word that Toby doesn't know.
Middle Cave:
Creatures of the New World: the characters at the party.
Inner Cave: Toby almost sees Bree undressed, not ready to reveal herself.
Regression:
Driving; what did you study?
Proximity: Blowing bubbles.
Deception Revealed: Toby sees that Bree has a penis.
Polarization: Toby ignores Bree; continues smoking.
Polarization: Toby doesn't speak to Bree in the car.
Journey to the Communion: Toby wants to go to Sammy's Wigwam.
Foreshadow of the Oracle: seeing the hitcher.
Communion: Toby tells that she has a Dick.
Communion: Bree walks away.
Communion: Arguing in the car; Bree tells Toby about the operation she wants.
Meeting the Oracle: Picking up the hitcher.
Meeting the Oracle: The hitcher endears himself.
Communion: The hitcher and Toby get undressed and swim in the pool.
Developing Characters and Relationships: talking while swimming.
Communion: Toby doesn't think Bree is a freak, just a liar.
Oracle Reveals: The hitcher steals the car.
Pushed to the Sword: walking and hitching the ride.
World of the Sword: on the back of the truck.
Seizing the Sword [Toby]: Toby picks up someone in the toilet and gets some money.
Seizing the Sword [Bree]: Bree meets Calvin Manygoats and gets a ride and a place to stay.
Developing Characters and Relationships: Bree sits with Calvin on the porch; "..keeps the dogs off the porch…"
Developing Characters and Relationships: Bree has the hots for Calvin.
Developing Characters and Relationships: the hat keeps the sun off my face better than a headband and a couple of eagle feathers.
Threshold Guardian: Bree goes to the powder room; Toby tries to tell Calvin that there's more to her than she's letting on.
Seizing the Sword: Calvin gives Bree his phone number and Toby a hat.
Near Death Experience: Toby asks for Sidney at the door; Elisabeth closes the door on him.
Resisting the Atonement: On the grass.
Atonement with the Father: Bree knocks on the door; Mom and Dad it's me.
Apotheosis: with her Dad; it's Subrina! we love you but we don't respect you; meeting Sidney; he's your grandson.
Ultimate Boon: the parents treat Toby really well.
Journey to / Foreshadow of the Elixir: Bree needs to borrow $1000 for the airfare.
Transforming: Bree gets ready and steals the tablets.
Transformation (New Clothes): Bree in her dress; Elizabeth combs Toby's hair.
Resisting the Transformation: arriving at dinner; Bree has to pull out Elizabeth's chair.
Transformation: the joint photo; Toby pulls out Bree's chair.
Journey to / Foreshadow of the Elixir: Bree asks to borrow $1000 for the airfare.
Guardain of the Elixir: Elizabeth tries to dissuade Bree from the operation.
Guardain of the Elixir: Elizabeth offers the money on condition that Toby stays.
Guardain of the Elixir: Elizabeth running after Toby.
Foreshadow of the Elixir: Bree wishes that they could just look at her and see her; Bree agrees to let Toby come and live with her.
Disgust / Refusal: Toby tries to sleep with Bree; Bree tells him she's his father.
Magic Flight:
Bree pursues Toby.
Bree recovers from the punch.
Toby disappears; putting out an APB.
Crossing the Return Threshold: Bree returns to the hospital and gets the operation.
Obstacle: after the operation; Bree unhappy that Toby has disappeared.
Obstacle: Toby in LA on the beach, taking drugs.
Master of Two Worlds: Bree a woman now.
Transformed: Bree a waitress, not a busboy now; learning Spanish.
Transformed: Toby doing porn as a blonde.
Freedom to Live: Toby turns up at Bree's door.
You can also receive a regular, free newsletter by entering your email address at this site.
Kal Bishop
**********************************
You are free to reproduce this article as long as no changes are made and the author's name and site URL are retained.
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What could possibly be worse than struggling with a painful condition and feeling ashamed to discuss the problem because of its intimate nature? Such is the case for many suffering with pudendal neuralgia, a little known disease that affects one of the most sensitive areas of the body. This area is innervated by the pudendal nerve, named after the Latin word for shame. Due to the location of the discomfort combined with inadequate knowledge, some physicians make reference to the pain as psychological. But nothing could be further from the truth. Unfortunately, discussing the condition with gynecologists, urologists and neurologists often proves fruitless since most know nothing about the condition and therefore cannot diagnose it.
Pudendal neuralgia is a chronic and painful condition that occurs in both men and women, although studies reveal that about two-thirds of those with the disease are women. The primary symptom is pain in the genitals or the anal-rectal area and the immense discomfort is usually worse when sitting. The pain tends to move around in the pelvic area and can occur on one or both sides of the body. Sufferers describe the pain as burning, knife-like or aching, stabbing, pinching, twisting and even numbness. These symptoms are usually accompanied by urinary problems, bowel problems and sexual dysfunction. Because the pudendal nerve is responsible for sexual pleasure and is one of the primary nerves related to orgasm, sexual activity is extremely painful, if not impossible for many pudendalites. When this nerve becomes damaged, irritated, or entrapped, and pudendal neuralgia sets in, life loses most of its pleasure.
So, where exactly is the pudendal nerve? It lies deep in the pelvis and follows a path that comes from the sacral area and later separates into three branches, one going to the anal-rectal area, one to the perineum, and one to the penis or clitoris. Since there are slight anatomic variations with each person, a patient’s symptoms can depend on which of the branches are affected, although often all three branches are involved. The fact that the pudendal nerve carries sensory, motor, and autonomic signals adds to the variety of symptoms that can be exhibited.
Because pudendal neuralgia is uncommon and can be similar to other diseases, it is often misdiagnosed, leading some to have inappropriate and unnecessary surgery. Early in the diagnosis process, it is crucially important to undergo an MRI of the lumbar-sacral and pelvic regions to determine that no tumors or cysts are pressing on the nerve. In addition, the patient should be screened for possible infections or immune diseases, as well as having an evaluation by a pelvic floor physical therapist to determine the health of the pelvic floor muscles and to uncover whether skeletal alignment abnormalities exist. An accurate patient history is needed to assess whether there has been a trauma or an injury to the nerve from surgery, childbirth, or exercise. Tests that offer additional diagnostic clues include sensory testing, the pudendal nerve motor latency test, and electromyography. A nerve block that provides several hours of relief is another tool that helps to determine if the pudendal nerve is the source of pain.
One of the most common symptoms that accompanies pudendal neuralgia is severe depression. Some people with the disease have committed suicide due to the intractable pain. For that reason, it is important to consider antidepressants, as they can help lessen the hypersensitivity of the genital area in addition to relieving bladder problems. Certain anti-seizure drugs reportedly help to alleviate neuropathic pain while anti-anxiety drugs provide substantial relief of muscle spasms and assist with sleeping. Uninformed physicians are reluctant to prescribe opiates for an illness that shows no visible abnormality, yet the desperate nature of genital nerve pain requires that opiates be prescribed for these patients. While medications are not always satisfactory, they do help take the edge off of the pain for many people. Until the correct treatment is determined, it is imperative that patients with pudendal neuralgia receive adequate pain management since the pain associated with this illness can be intense.
Treatment depends on the cause of distress to the nerve. When the cause is not obvious patients are advised to try the least invasive and least risky therapies initially.
Physical therapy that includes myofascial release and trigger point therapy internally through the vagina or rectum assists with relaxing of the pelvic floor, especially if pelvic floor dysfunction is the cause of nerve irritation. If no improvement is found after six to twelve sessions, nerve damage or nerve entrapment might be considered.Botox is now used in medical settings to relax muscles and shows promise when injected into pelvic floor muscles; though finding a physician adept at this treatment is difficult.Pudendal nerve blocks using a long-acting analgesic and a steroid can reduce the nerve inflammation and are usually given in a series of three injections four to six weeks apart. If physical therapy, Botox, and nerve injections fail to provide adequate relief, some patients opt for pudendal nerve decompression surgery. There are three published approaches to pudendal nerve decompression surgery but there is debate among members of the pudendal nerve entrapment community as to which approach is the best. Since there are advantages and disadvantages to each approach, patients face considerable confusion when deciding which type of surgery to choose. Because there are only a handful of surgeons in the world who perform these surgeries, most patients have to travel long distances for help. Moreover, the recovery period is often painful and takes anywhere from six months to several years since nerves heal very slowly. Unfortunately, early statistics indicate that only 60 to 80 percent of surgeries are successful in offering at least a 50 percent improvement. Patients whose surgeries are not successful or who do not wish to pursue surgery have the option of trying an intrathecal pain pump which delivers pain medication locally and helps to avoid some of the side effects of oral medications. Others pursue the option of a neurostimulator either to the sacral area or directly to the pudendal nerves. These are relatively new therapies for pudendal neuralgia so it is difficult to predict success rates. Some pudendalites have devised ingenious contraptions for pain relief ranging from u-shaped cushions cut from garden pads all the way to balloons filled with water, frozen, and inserted into the vagina. Most have a favorite cushion for sitting and many have special computer set-ups for home and office use in order to avoid sitting. Generally speaking, jeans are a no-no, so patients revise their wardrobes to include baggy pants and baggy underwear – if they are able to tolerate wearing underwear.
Clearly more research is required to find effective methods to better manage the pain and debilitation of pudendal neuralgia. But in the meantime, friends and family close to those who have this devastating illness play a huge role in helping patients cope, thereby maintaining the best quality of life possible. Support, love and understanding are of primary importance for those suffering with this affliction.
