Do not be worried, I am not trying to get you to prescribe me more vicodin. I have used only three or four of the pills you gave me last December, and am not ‒ yet ‒ so desperate with regards to money that I tried to sell the rest on the black market.

It is actually a rather complex story.

As I briefly mentioned (only to answer your questions about my general health honestly, if somewhat bluntly) to you the first time we met (and believe me, I was not feeling as casual about it as I might have appeared), I have vaginism. Or vaginismus. Why can't people agree on the name of this shit?

I started pelvic physical therapy in September 06 and have made tremendous progress since then, there is no doubt about that. I went from panicking when anybody (me included) had their fingers outside the opening of my vagina and not being able to introduce a q-tip to being able to have almost painless intercourse (under a variety of conditions which, thankfully, do not include any kind of drugs).

But.

I am still not cured. I still have weird pains, and spasms. Mainly rectal spasms. (As you can guess, this is not a conversation I have very often. Rectal spasms do not seem to go hand in hand with social etiquette ‒ go figure). And the spasms don't go. I've tried exercises (still doing those, still no result). I've tried various kind of muscle relaxants, both as topical creams and as suppositories. I'm currently taking an anti-spasm oral drug that don't do much except for side effects. I'm also trying on electrical stimulations, and they don't seem to do much more than allowing me to lie down for fifteen minutes every day and try to relax.

And my physical therapist is kind of puzzled. The gynecologists are also running out of ideas.

The situation, my physical therapist says, is so complex that I would make a very nice case study. (I would not be surprised to learn that I am, indeed a case study ‒ part of the documents I have signed allow them to do so.) It's all connected, the hips, the pelvic floor, the rectum, the vagina, and the lower back.

So, why I'm here?

Because it seems that the nerves involved in my spasms branch from the sacral nerve. And it also seems that my sacral area is kind of messed up ‒ with the vertebrae looking twisted and out of alignment and, in a word, not quite right. Yes, that's three words. Let's live with it, if you will.

So that's point one ‒ is anything wrong with my sacral vertebrae to the point that there could be something going on with the sacral nerve?

Point two is very simple: sometimes, my tail bone hurts. On the left side. Which is my messed up side (the disc, the intensity of the vaginal pain, the short leg ‒ remember the short leg?).

The short leg is point three. If you remember, my left leg is shorter than the right one. By about ten millimeters. We noticed it when I was fourteen and had sciaticas. My pelvic floor grew slanted because of it, causing the spine to make a C. Not a scoliosis, just a C. So I'm wearing a ten millimeters wedge in my left shoe, and you checked in December that it was still adapted. But weird things happen. See, my physical therapist noticed, as I was laying on my back, that my left hip was too high. As if the left leg was shoved up. So she made me stand up (barefoot). And sure, the left leg was shoved up. But the left leg is shorter! When my feet are aligned, it should come lower than the other one, not higher. That was surprising, so I took my wedge out of my shoe and stood on it. My hips were normal. We didn't understand it ‒ you put my foot higher and the hips get lower? Maybe this had to do with it being a wedge and not a full insole, therefore inducing weird rotations of the hip, I suggested. So I stood with my left foot flat on a book which was about the right thickness. And my hip was still normal. I have no idea what's going on. My physical therapist, who was specialized in back problems before moving to pelvic floor, has no idea what's going on.

So, yes, Doctor. That's why I'm here today. In a nutshell.

I'm seeing him tomorrow and hope not to forget anything. I have notes.