Unable to perform biopsy
Posted , 6 users are following.
A little background first, since this is my first time posting (although I've done a TON of reading over the past few days). I've been dealing with the itching,rawness and painful sex for a little over a year now (painful sex was the reason for the initial Dr visit). After being put on various steroid creams, estrogen cream, etc. I was referred for pelvic floor physical therapy. Shortly after starting that, the skin problems came back and my PT was the first to suggest lichen sclerosus (of which no one had mentioned this diagnosis before). Back to the gyn, more steroid creams (bethamethasone valerate for 2 weeks, then alcomethasone every couple of days). I am not suffering the worse flare up I've had thus far, so my PT suggested a nearby vulvar clinic to be referred to, since my gyn obviously is not helping things.
I hadn't had a biopsy at this point, so my gyn suggested going ahead and doing that since it will likely take some time to get into the vulvar clinic. Since I had been researching all weekend and was frustrated that no one had suggested this before, I was all for it. I went in today and we began the procedure. I got my first shot of lidocaine, waited a few minutes, but when he pinched to see if it was numb, it DEFINITELY was not! So I got to endure another shot of lidocaine. Waited a few minutes and it was better, but nowhere what it needed to be to continue with the biopsy. He decided to give it another 10 minutes for it to work, came back and tried the pinch test again, but it was as though he had never used any lidocaine! I know everyone in the rooms around me heard me holler and I about came off the table. I'll go through childbirth or a gallbladder attack ANY day before wanting to have my most irritated, raw, sensitive area of my body have to feel that pain again.
We agreed to not go further with the biopsy for today, for two reasons. The gyn suspects that this area has been inflammed and painful/irritated for so long that the nerves are so incredibly sensitive that the lidocaine just wasn't doing the trick. Since we were already doing the referral to the vulvar clinic, he felt it would be best to let them do it, since they would have more experience with vulvar pain and the nerve sensitivites. He was also concerned that if it hurt this bad just numbing the area, how much more would it hurt after the biopsy was performed and the numbing wore off? He also felt that the area, although it looked bad, was not concerning enough to suspect cancer and where we would have to push through to get the biopsy done.
I'm glad we stopped because at this point, my emotions and mental state could not handle another needle being inserted into my raw vulva. But I'm also frustrated, because I was at least looking foward to having a definitive diagnosis - maybe we're treating for the wrong thing? Has any not been able to go through with a biopsy because of sensitive nerves/not being able to be numbed with lidocaine?
0 likes, 6 replies
car1811 jsanderson0508
Posted
Hi
I've been diagnosed for around 3 years now with no biopsy. A biopsy is something I strongly considered as my Lichens really effects my mental health (you may have seen some posts at the height of my latest paranoia). I took some advice that i'll repeat to you. If you have been given a diagnosis do you really need to put yourself through the pain of getting what is already a horribly sensitive area cut into? If it is diagnosed as Lichens then there will likely be no change in what is prescribed. I have now been steroid free for maybe around 1 and a half years at least. I have tried so many steroids to no avail. Sadly there is little research and no cure for lichens. I've recently been seeing a chinese doctor and although not cured my symptoms are more bareable. I have also tried to limit my sweet treats and alcohol as well as eat a more balanced diet. I am a vegetarian but my Chinese doctor said to avoid seafood always and to try to incorperate some chicken and then red meat back into my diet. I know this doesnt answer your question directly but do think about it before you rush into something. Big hugs.
Vita23 jsanderson0508
Posted
Hi, if there are white spots, it is lichen scletosis. I have had a biopsy, and it was painful. It was even more painful after that, but Motrin helped. The area was swollen for a week or two, yet I think all that swelling and blood inflow helped the area recover from the white spots. I also used a combo cream of an antifungal and a steroid. Clobetasol wasn't helpful. The no sugar, no white bread diet helped, and the antifungal especially. I also dramk herbal supplements that fight parasites snd bacteria, and lots if real sour cranberry juice for the itch. See a naturopath to check your overall condition and immune system. Try to reduce the stress. Drink bitters for the liver, and immune or adaptogenic teas. Check your B vitamins. A good miltivitamin for a short time may help you. Choose one with methylated B vitamins. I also take curcumin for immune system, too.
beverly52803 Vita23
Posted
vita, was the cream nystatin? I used that along with estradiol for a while, but I think a round of flagyl helped more. I had no external itch. Mine began with an internal itch which brought me to the gyn. The LS diagnosis was a shock. The internal itch is now completely gone, but I think it was exacerbated by heat.
I have had very good results with oriental medicine in the past for other issues and want to try it again for the LS. Will have to wait for the spring when I return home. Wonder if anyone has tried homeopathy?
Which tea do you drink? Is it specifically for immune systems? I have been drinking ginger and pau d'arco, but only based on generalities.
sarb73328 jsanderson0508
Posted
I have never had a biopsy for LS. Gynae diagnosed it just by looking and a dermatologist told me yesterday that you really only need one if they suspect anything different. So perhaps you don't need to put yourself through it especially now while you are that sensitive. I can understand you wanting a definite diagnosis so hopefully the vulva clinic will be able to give you that by examining you. Meantime keep up with the steroid?
sarb73328 jsanderson0508
Posted
PS to my last: I have never had white patches, my diagnosis was made because of the presence of fusing.
Su02 jsanderson0508
Posted
ive been diagnosed 5 months by examination. Have my re check next month. Biopsy is an option when i go back. I have no doubt its LS so unless they think something looks ab normal i would most probably opt out! Ive found its all trial and error. I did the specified weeks of same steroid(BETNOVATE) just once a week now but it does irritate at times. I just stick SUDERCREM for sore bits, liquid castor oil to keep soft and hydromol for washing down there. Generally keeps it bearable. Turmeric tea, vitamin D3 . I still enjoy my alcohol at weekends bugger this LS . You will get there j Sanderson x