What a miracle this steroid cream is! I put it on and within an hour, I feel something I’ve never felt before. The pain, of burning and heat is replaced by a delicate feeling of wholeness, gentle presence and delicate fine-edged sensation. The feeling of gentle spray from my hand-helf shower head as I clean my vulva was takes my breath away, intimate and light and full-textured, in a way I haven’t ever felt, perhaps ever. It’s hard to describe without resorting to language that may seem hokey. My vulva feels like it comes from an angel’s body, irridescent and soft and a sacred gift, so strong and yet so delicately sensory. Is this what other women’s vulvae feel like to you? You all are so blessed.
This is what it feels like to have a healthy, whole vulva, and it brings me to tears. I am so grateful and I want it so fiercely. I feel so much more, and I can have sex that is both gloriously sensory-rich and which I can have without paying for it afterwards in a currency of pain. I desperately hope that when this month of daily use is over, the inflammation is down so much that once or twice a week will keep me in this state. As it sits now, I have 6-10 hours of relief, and the pain and inflammation bounce back thereafter. My pink vulva goes back to a hot inflamed red. I may try using the cream at bedtime to see if that keeps it active for longer. This cream can’t be used daily for more than a month.
Once complication so far is that I have had what feels like a urinary tract infection since two days after starting the cream. I have had these in the past, and normally they go quickly when confronted with my two pronged treatment of drinking huge amounts of water (to dilute the bacteria and make the pee feel less caustic) and large amounts of vitamin C (excess vitamin C is excreted in the urine, making it acidic. Vitamin C is also called ascorbic acid. The change in pH kills the bacteria. However, I think that it is possible that the cream is irritating my urethra and making it feel like I have an infection, or I have an infection and the steroid cream is slowing down the healing of the opening to my urethra.
Another possible complication is that my voice is a bit husky. I sang in a concert yesterday and in the tech rehearsal I coughed during my final high note on one of the songs. This is one of the known side effects of the steroid cream I’m using. Again I hope this is something that is mostly about the cold I had last week taking time to heal or something that will drop off when I am using the cream less frequently.
I need to research and build in a habit of doing everything I can think of that reduces inflammation in the body. Perhaps now that I know what is going on, I can manage it more globally, again reducing the need for the cream. I’m feeling pretty darn motivated.
So I had my follow up visit with the gyne specialist last Friday.
Here’s the skinny. I do not have planus lichen (SO glad I went ahead with the biopsy!) Instead I have a ‘chronic inflammatory skin condition’ of the vulva. Basically, she said that the technician could see that I had a chronic inflammatory condition from the tissue sample.
The worst inflammation, according to her, is right where the red is in this drawing. Do you think that it’s a coincidence that I have a chronic inflammatory condition right at the site of the most serious physical injury I’ve ever had? Nope. Me neither.
Luckily, even though it’s not something with it’s own name, there is a treatment. She gave me a prescription for a really strong steroid ointment. I use a tiny amount on the ‘affected area’ as it says on the jar, and then wash my hands really well, since we don’t want them getting ‘treated’.
I am to use it once a day until my vulva is no longer inflamed, to a maximum of a month, and probably about two weeks. You apparently don’t want to use this steroid daily for longer than that or it makes the skin thin.
After than I am to keep the ointment to use for flare ups, and can use it up to twice a week.
The good news is that it seems to be working. My vulva feels different, not sure exactly how yet. My wife says it looks a lot better and less red. I have had one flare up since I started using it, a bad one, but since I’m having a lot more sex now than I used to, that isn’t entirely surprising.
On the poly relationship front, I have a wife and a girlfriend. Who have met one another. And who seem to like one another. I spend weekdays with my wife and weekends with my girlfriend. My wife also seems to be getting her sex drive back. Yay! This is a very good time to have a well functioning vulva.
First off, the specialist did not help me assess the damage from the assault. I was disappointed. However, she did have a very credible theory for what could be causing my pain and took a biopsy to confirm. The biopsy was freaking painful and caused a lot of bleeding (they cut off a small piece of flesh to look at under the microscope) but can be used to confirm the diagnosis.
The diagnosis she’s testing with the biopsy is vulvar lichen planus. It’s an inflammatory condition of the skin, that women sometimes get on the vulva. I have most of the symptoms and the doctor thought there was a good chance that’s what it is. Basically it makes your vulva and vagina look and feel like you’ve had a bad sunburn. I looked up some pictures to add to this post, but I don’t want to inflict them on you. They’re not pretty.
The gyne wasn’t keen to remove the flesh tag from my vagina, she thought it might cause more scarring. I’m willing to wait to assess that till the lichen planus (if that’s what it is) gets under control. If there are any other women out there who have kept or removed flesh tags from the vaginal opening and want to weigh in on whether it was a good thing, I’d love to hear your comments.
Lichen planus is thought to be an autoimmune disease, but they’re not positive about that. It does run in families a bit too.
One source said that because it’s autoimmune, avoiding allergy triggers or taking antihistamines could help. However, primarily it’s treated with steroid creams, or if that doesn’t work, oral steroids.
She couldn’t prescribe the cream now, because the hole from the biopsy has to heal first, which will take about a week. I can’t get another appointment to see her for a month, so that’s how long it will take.
In the meanwhile I’m going to (sigh!) try and eliminate dairy and gluten, both of whom I have mild allergic responses to, in the hopes that will help calm my immune system down. There are lots of things that are helpful for calming down autoimmune issues too, so I’ll look into those and try them out.
All in all, it’s hopeful. I may be able to have sex without pain and itching afterward. That’d be pretty awesome.
Here’s an excerpt from the typed page I’m giving to the Ob/Gyn specialist later this morning:
“What I am here for:
1) My goal is to improve my ability to mitigate the impact of my injuries on my sex life and daily level of pain and discomfort. I’d like help to figure out how not to have any pain at all on a daily basis. I also would like to have a clear understanding of the damage (tearing, vascular, nerve?) so that I can modify sexual activities to have pleasure and avoid pain, and to comfortably and pleasurably have sex more frequently.
2) Is there anything about my physiology following the injuries that makes it more likely for me to experience vaginal infections or pain around my urethra. If so, what can I do as self care to compensate for this? (I already do all the usual things – cotton panties, no douching, no scented products)
3) I would like a very thorough assessment of what damage was done by the assaults. Where any tearing might have happened. My research indicates that vaginal injuries in childhood tend to heal without scarring, and the fact that I have scars suggests either repeated or deeper damage, so it’s possible there were other injuries that are not as apparent. Children who are raped apparently typically tear toward the anus, and my scars are in the other direction. I’d like to know specifically where any tears are, were or may have been, where any scarring, nerve damage or vascular damage is and where any flesh tags are. I think this information will help me work around them and mitigate them
4) I would like to discuss the possibility of removing any flesh tags that are getting rubbed during penetrative sex and what the impact of that might be.”
I feel really calm, centered. I had a little cry in the shower this morning, but it was full of gratitude for the support and for the women and men who are walking beside me in this. I know that the Goddess has my back. I am meeting more and more survivors who have experienced vaginal damage. Women, I am doing this for me, but I am doing it for you too. Thank you for walking beside me in this. May we all be blessed. May we all outlive our abusers and dance on their graves.
Note: This is probably triggering.It’s medical studies talking about vulva injuries in kids and how they heal. Read at your own risk. Here is a nice picture of a bunny to give you the opportunity to not read what is below if you don’t want to.
I am doing some research to help find an appropriate specialist to treat my vulvar injuries. I have found some disturbing things out.
Apparently injuries to the vulva bleed a lot, and you can die. Some sources recommended examining injured children under anasthesia, because it’s really common for there be other internal injuries (tearing into the urethra or anus). In places in the world where young women and children are commonly raped and mutilated genitally, things like ‘fistulas’ are common, which is where the wall between the colon and the vagina has a hole in it, and fecal matter gets into the vagina. My heart goes out to those women. I sure hope I have nothing like that. Surely I would have noticed?
And generally, tears in the vulva inflicted as children usually heal well and quickly without scarring, unless they are particularly deep and severe. Lucky me. I have two really long, very evident scars. So survivors who know you were injured, don’t feel invalidated if you haven’t got scars. Most women don’t. Reading this, I think that it’s is likely that there were other less severe tears that healed up without leaving a lot of signs. Also, the scars from tearing during rape, in adults anyhow, tend to rip backward toward the anus (if that’s how I understand posterior in this context), which is the opposite of what happened to me. Here’s the reference on that:
Here’s an excerpt from one of the few references I found that wasn’t about tearing during birthing. “Healing of Nonhymenal Genital Injuries in Prepubertal and Adolescent Girls: A Descriptive Study”:
Superficial vestibular lacerations seemed healed in 2 days, whereas deep perineal lacerations required up to 20 days. The appearance of new blood vessel formation was detected only in prepubertal girls, whereas scar tissue formation occurred only after a deep laceration in both groups. [emphasis added]
I’ve looked at some diagrams and there doesn’t seem to be a name for the part of my anatomy that got torn, basically between the vestibule, through the urethra to the clitoris. Although if the diagram of the child sized vulva is accurate, that space was a lot shorter when I was a child.
Probably the most disturbing thing though is that looking up ‘reconstructive gynecology’ brings up listings for ‘vaginal rejuvenation’ surgery, where women get their labia cosmetically altered to make them prettier, and get their vagina ‘tightened up’. That is the most misogynist thing I’ve heard of in a long time. I need reconstructive surgery from a horrible injury. Y’all with intact vaginae and vulvae should be grateful, and not damage them with unnecessary surgery to make your vagina/vulva lookbetter. Outrageous. Seriously. Sheesh!
First, some background. I had sex for the first time with a new lover recently and my vulva was really not happy afterward, directly related to my injuries. First off, my lover did not respond well to being told I had scars/injuries on my vulva (she ignored the comment. really?) and then was much rougher with me than my sensitive peach can handle. Yes, I probably shouldn’t have continued having sex with her, but you know, sometimes you make a call at the time. I changed the activity, but by then the damage was done. Now I know. Next time I’ll be more firm about what can and cannot happen up front.
The flesh tag at the mouth of my vagina got rubbed raw and my poor peach hurt for days. It was what most women would consider ordinary sexual activities, none of which would have been unusually rough treatment for an uninjured vagina/vulva.
So I put my foot down, and decided by golly I was going to find a doctor and get this sorted. I tried at first to find a family doctor with some street cred about sexual assault. This was a disaster, as the doctor I found at first was, and then was not accepting patients. The sexual assault centre didn’t have anyone to recommend, and I ended the day in tears.
I waited a week or two to cool down and then a couple of days ago I decided to just go into the walk-in clinic and ask for a referral to a specialist there. Here’s what I did right:
I asked my wife to come with me. She made me eat first so I wouldn’t be low blood sugar, kept me company in the waiting room, and also wrote down what the doctor said.
I asked for support. I messaged four of my friends who know about the injuries and told them what I was doing and asked for energetic support. I said I wanted to avoid crying and find an effective referral. They sent me supportive messages back that I read in the waiting room.
I dressed up. I wore business-casual clothing, did my hair, applied light makeup. Office armor.
I introduced myself and my wife to the doctor with our first names, to make us real people.
I brought a printout of a photo I’d taken of my vulva that clearly shows the scars. This turned out to be a brilliant idea, as I could show the doctor the scars without having to undress.
Some good phrases I used: “I’m looking for a referral to a specialist to address some injuries from a sexual assault.” “I didn’t receive medical attention, but that doesn’t mean I didn’t need medical attention.” “It healed badly and affects my sex life now.” “I have a picture of the injury.”
I pulled out my printout of the photo my wife took for me. (If you take a photo of your own injury I recommend using a flash, as it shows the scars more clearly) and pointed out the two long lines of scars. Having the photo also allowed me to point out where the flesh tag is and where the vascular damage is.
The doctor said he would try and track down a suitable specialist for me and gave me a timeline for how long he thought it would take. A couple of weeks for him to find someone suitable (he gave me some internet search terms to look under if I wanted to try and find someone myself) and then 3-9 months to get in. He consulted with me about whether I should see an Ob/Gyn (who might have experience with similar injuries from birthing tears) or a reconstructive gynecologist. All in all he was very nice and I was happy about what happened. He said that removing the flesh tag would be straightforward but that there might be scarring which might be problematic. I told him I just wanted to see what I was dealing with and what could be done, surgically and non-surgically, to mitigate it. (I probably used the word mitigate. I’m like that.) Yay.
I am an amazon! I had a pap test and negotiated for what I needed. Yay me.
I went to the drop in clinic today because I have a stomach bug (at least that’s what I thought) that wasn’t going away. The doctor ruled out the bug pretty quickly and then asked if I had pap tests regularly. I said no. She asked if I was ready to have one today. I decided I was up for it. She wanted to check and see if there was something wrong with my uterus. I decided I was.
She handed me a paper sheet and was about to leave the room when I said “can I sit up for the test?” At first she said no. If I hadn’t already had a perfectly normal pap test sitting up, I would have believed her. I explained how the other woman had done it with the back of the table up. She said “I don’t know how to do it that way”. I said “I’m a rape survivor and I’d be more comfortable.” Her face softened an almost imperceptible amount and she said she would try.
I told her that the other woman had lifted up the back part of the table. She set it to an upright position and left the room so I could change. I’m not sure if she went online and looked up how to do it, because she was gone for awhile.
When she came back she had me sit on the table with my knees bent and my feet touching, then allow my knees to fall apart from each other. I think this was the part she looked up. She didn’t use the stirrups. This was actually even better than sitting up with the stirrups. Then she did the pap test pretty normally and fast. She seemed impressed that it wasn’t any harder to do in that position. I told her that a group of doctors in Alberta had published a booklet that suggested it as a better way to do pap tests for survivors, and it certainly worked better for me. She said it might be a good new way to do it for everyone, since most women don’t like to lay down (it sounded like herself included).
Rape survivor is so much easier to say, and yet still correct, than childhood sexual assault survivor, incest survivor or any of the terms that bring in the messy details of my age when it happened or who was the perpetrator.
Anyhow, I came through unscathed, no meltdown, no triggers, feeling empowered. I think I have this blog to thank for being able to be so articulate with my doctor. I’ve gotten so much more comfortable with thinking about and talking about my vulva and what I need as a survivor. It’s really common after all.
My next step I think is to try and find a specialist to do some reconstructive surgery on my vulva, and get rid of those little sore tags of flesh.
I had an interesting experience having a massage today. I had a sore hip due to what my chiropractor says is a tight ‘IT band’. The massage therapist was doing various things to loosen this and I was asking her what might have caused it to get so tight.
Between the two of us we figured it is probably due to my sleeping position, which not coincidentally, is as different as possible from the one I was raped in. She asked if I was uncomfortable sleeping on my back and rather than lying I said calmly. “Yes, but not physically. Trauma. Emotional. But it’s a lot better now.” Typical stock survivor response, acknowledge the facts as calmly as possible, combined with reassuring the listener I’m not going to fall apart on them. However, I meant it. I *am* fine. She said that was good, and continued on.
Now some massage therapists get uncomfortable when you say things like this, but this one didn’t. A woman would know exactly what traumatic event would happen when a woman is on her back. There was not much more to be said.
Earlier in the session she’d been working on the back of my neck and I said, “oh, one thing I forgot. If you work on the front of my neck, please let me know first please.” She’d also accepted this well.
When it came time for her to work on the front of my neck she warned me and was gentle, asking what types of touch to avoid. She got it.
I asked her how my neck was. I’m curious. I have no idea how being strangled has affected my neck. She said something like it was very siezed up and tense. I said, well it makes sense, the soul and body are connected, and she agreed.
At the end of the session we agreed that my IT band and leg needed more work and so did my neck. I said, if we work on the neck it will need a session just for that, and I’ll probably cry. I’ll need to have my car nearby so I can go to it to calm down afterward. I told her I look after myself just fine, but that there is likely to be emotion connected to the tension. She was great. She told me that it happens all the time, that people often have feelings come up during or after sessions and she considers it an honour to help people clear. Her energy felt grounded and sincere.
On the way home in the car I sang my scar song about the abuse to clear some of the built up emotion from having my neck worked on. I had an inner child reaction which led to me going to bed curled up in a quilt for a few hours, after which I felt more clear.
I have booked a session for next weekend. I’m not sure if we’ll work on the neck or the leg. I’m proud of how matter of fact I was, and how well the interaction went. Unexpected. I’m used to being more guarded with health care folks, so they don’t treat me funny.
I’m looking forward to having body work done in a context that allows me to release the feeling. Not looking forward to cleaning up the reaction afterward, but hopefully if I can release fairly fully it’ll be more relief than triggering. One can hope.
The picture I chose to go with this post is of baby birds, who were rescued after their nest was blown out of a tree by the photographer. At first I rejected the picture, as it is not the strength and confidence I felt today. However, the vulnerability of the birds and their long necks resonates with the vulnerability I feel in my own neck and this situation. There are some very intense, fragile and wounded sensations locked away in my neck tissue and this picture owns that. Telling the truth, being as vulnerable and strong as I actually am is a far stronger and more courageous place to be in. [the photographer took down the photo I had linked to.]
My vulva has been very sore the last several days. Over the years I’ve made several attempts to try and figure out what is wrong and fix it.
As you may know, I was raped repeatedly as a small child, and my vagina/vulva was injured. From the scars and my memories of the pain, I’d say it tore from vaginal vestibule (the opening) in two places right over to my clitoris. Just thinking about that makes me want to cross my legs.
When I was a young adult (18) I began having intercourse with my then boyfriend, who was about my age. I had what I thought at the time were horrible bladder infections and yeast infections, so bad that I’d have to sit in the bath in order to control the pain when I peed. The wrinkles in condoms would cause enough friction that I’d be very sore. During this time the doctor also found a sore he thought was herpes. He tested it and it was negative. I still don’t know what it was. I’ve had other sores since, but rarely. Gods only know what I would have been exposed to from my father, but I’ve gotten a full STD test panel and was negative for everything, which is a blessing.
I didn’t have the knowledge or assertiveness then that I have now. I went to the doctor a few times, but really they weren’t able to to resolve things so that they didn’t hurt. I researched all the usual helpful things:
I never did use scented stuff near the peach (scented pantiliners, soaps, lotions, douches etc… which are supposed to cause reactions.
I had a doctor tell me to douche with plain vinegar and water to kill the bad bacteria and then insert a slurry of yogurt and water to restore the good bacteria. Later the same doctor told me to put boric acid in gelatin capsules and insert one when I had symptoms.
I bought soft cloth menstrual pads instead of the rough paper ones.
I wore/wear only cotton underwear
I had another doctor tell me to use a blow dryer set on cool to dry my vulva after a shower or bath.
All of these things undoubtedly helped a bit, but don’t go all the way and it keeps coming back.
A few years later, having regular painful sex with another boyfriend, I went for several visits to my family doctor to see if I could clear it up once and for all. I told her I thought I had a persistent low grade yeast infection and vowed to keep going back again and again until it cleared up. She prescribed the anti-yeast vaginal suppositories, and I did that. A couple of weeks later, still sore. I went back. Puzzled, she tested me for diabetes and AIDS, which apparently both can cause recurrent yeast infections. Negative. I told her I was a survivor. She was very uncomfortable. I didn’t go back. She went on mat leave and I didn’t see her again.
A couple of years ago I went to a nurse practitioner (kind of like a super-powered nurse who does some of the things a doctor does) and told her about my little problem. I went in when the pain was pretty bad and she could see and feel the red, inflamed tissue. She told me she thought I had vascular damage from the rapes and pointed out my scars. She suggested putting cold packs on my vulva and tested me for infections (all negative). Then, after some promising and useful work, she gave up and suggested it might be psychosomatic. I don’t think it could be this persistent and steady if it is psychosomatic, and I’m generally not in a lot of denial about my abuse issues, so if it was really a body memory, you’d think I’d have processed it by now, I tend to not shy away from dealing with this kind of thing. I think that an injury for which I didn’t get medical attention plus vascular damage might be a more credible cause, frankly, so I’d like to find someone knowledgeable to look at that.
I did some research and found out about vulvadynia, which I’ve written about on this blog before. The main self-care strategy for this is mostly to rinse your vulva with water after peeing to prevent the urine from irritating the sensitive tissue. This has taken my pain down a few notches, particularly in the morning, but not completely.I also read that perhaps clenching the muscles in the area can cause reduced blood flow which causes pain. I’ve been paying attention to not doing this, so it’s not related to the current pain I’ve got.
I know when you hear hoofbeats, think horse not zebra, but given that I have a zebra kind of injury here, and the usual causes have already been ruled out, it’s time for a little digging.
I’m girding my loins (so to speak) to make another pass at trying to figure out what is going on here. I’m assuming I need some kind of specialist – but who? ob/gyn? midwife? . I googled “long term effects of vaginal injury” and got nothing. There’s a bit on STV’s in children but mostly for doctors on how to test for them following child sexual assault.
I’d like to summarize what resources and history I’ve gathered (or created) that might be helpful to other survivors.
I went from someone who had an 8 year gap in both pap tests and dental work to someone who has had a pap test and a dental cleaning within the past year. I also successfully asked a health clinician doing my pap test to examine me for scar tissue from the rapes (I have evidence of tearing that no-one had mentioned to me previously.)
The day before the pap_Yesterday I saw my therapist and we talked about the pap test appointment tomorrow. What’s different about this appointment is: 1) the medical professional will know I’m a survivor. 2) I’m planning to ask if I have scar tissue. 3) …
Warrior Victorious in Pap Test – So the gyne visit went about as well as it could possibly go, and better than I could have envisioned. The nurse-practitioner I saw was very experienced and nice and drew the correct line between warm sympathy and matter of …
In the wake of proof – Knowing I have scar tissue has changed my life I think. It’s like an incontrovertible validation of what I’ve been saying all along. No longer can I doubt or go into denial about the accuracy of my memory. I know …
Icing my vulva – I’ve had pain and itching in my vulva for most of my life. I’ve worn out holes in the fronts of underwear from scratching. This, I’ve found through some recent reading, is actually pretty common with vaginal injuries like mine.
And last but not least here’s a resource I created:
I’m really proud of this one. Wouldn’t you like to just hand your doctor a form with checkboxes for the accommodations you need to be able to tolerate a pap test? No working up to disclosing abuse just before getting into the stirrups, no worrying your voice will break or you’ll lose your nerve. All you have to do is hand over a piece of official looking paper. Look no more, here’s my survivor-designed and field-tested version, made using some of the recommendations from the sensitive practice guide linked above: SwordDanceWarrior’s Information Sheet for Gynecological Care Providers Providing Care to Childhood Sexual Assault Survivors I’ve used it. It works beautifully. I ended up in my own clothes rather than a gown, sitting up with a mirror so I could see what she was doing, with everything explained as she went along, and with my partner present. It was way less stressful than a regular pap test. If you use it, I’d love to know how it went.
I’m regretting the bar of chocolate I ate at the movie, whose caffeine might be what is keeping me awake. Mydog is ecstatic to be on my lap rather than in her bed beside our bed, but is interfering with my typing, as seems to be the Goddess given role of all small furry pets.
She occasionally gives me a little body language “what, are you still typing rather than petting me?” What can I be thinking?
What I’m obsessing about tonight is my hurt feelings about some volunteer work I’ve been doing. The women-run organization I’ve been donating some computer work to has rather high-handedly decided to hire a man (one of the women’s sons) to do the job I’ve been doing for free. I’m sure it’s personal, as the work itself I’ve done has been high calibre, prompt and efficient.I’ve ruffled some feminine oligarch’s feathers and have been replaced. The funny thing is that this organization prides itself on making decisions by consensus, and I know the woman I report to was not in favour of replacing me, which means she was outvoted by someone, a thing that is against the orthodoxy of consensus.
It is my unfortunate habit of pointing out just this type of thing that has made me unpopular. One of my favourite authors, Lois McMaster-Bujold, has a character who says something to the effect that the difference between honour and reputation is that your honour is what you know to be true about yourself, and your reputation is what others think, and to guard your honour and let your reputation take care of itself, honour is far more important. You need to be able to live with yourself, above all.
Unless I have one or more alter personalities I don’t know about (which I suppose is scarily possible, given how little I know about my childhood), I’ve done nothing to be ashamed of. I am a bit too willing to point out elephants in the middle of respectable living rooms, and a bit too inclined to be blunt. Having been raised with only brothers, and a survivor of extreme abuse to boot, I’m not particularly polished in my women among women communication skills, to say the least. I tend to say what I mean, and expect others to do the same.
Anyhow, my feelings are hurt. Very hurt. I want to prove to them that they are wrong and I am right, and yet I understand that that is impossible.
My dog has once again gotten up, looked over at my overly bright screen and given me a look. Would I puh-leeze stop making typing noises and turn that light out?
My wife went to see the doctor today, who kept her waiting for an hour and then was dismissive to her. She did, however, write her a prescription for the two hormones that my research said would help her sleep, stop having hot flashes and make her peach more resilient. My brave wife talked about her lesbian sexual issues affecting her relationship with her straight, impatient, rushed doctor, and despite being brushed off, managed to get some of her needs met. She is in fact sleeping in the other room, which means that the progesterone is working as advertised.
In Canada, doctors don’t really have to care whether you are happy with how they treat you. Somebody really really needs to do a patient satisfaction survey. Don’t get me wrong, I’d much rather be sick in Canada than say the US, unless I was independently wealthy, but the bean counters that tell doctors how much time they can bill for a doctors’ visit are woefully misguided about how long it takes to do a competent job. Lesbians, in particular, don’t go to doctors often, and so when we do go, it’s because we have something chronic that we can’t fix on our own, or serious and acute. Iether way, fifteen rushed, impatient minutes aren’t going to do it, particularly when it’s something sensitive and hard to talk about. I told my wife how proud I am of her bravery and gave her lots of love.
I really hope this helps. Our marriage needs her to be able to be physically affectionate with me again, to be able to cuddle without a sweaty hot flash, and to sleep well enough that she’s not achey and constantly cranky. I’m too young to stop having sex, and I’d rather break up that consign myself to a lifetime of celibacy.
I have to remember that I have people who love me, and that my honour is more important than my reputation.
I am proud of managing to eat and drink healthier. I’m drinking a lot more water than before, and eating smaller portions, slower, for the most part. I haven’t lost any weight, but I’m pleased at the better habits. I’ve also been doing more chores, something that is only fair. I’ve been listening to a hypnosis recording about the positive diet and exercise habits,and am pleased at how it is sinking in. I listened to it tonight, hoping the voice would lull me, but no dice.
Honour before reputation! I trust and believe in myself and that’s what’s important, I tell myself. However, it is frustrating to have such terrible skills or something with women’s groups. Seeing how I’m a lesbian, it’s a bit inconvenient. It seems to also be mostly cliquey older women I run afoul of. I can think of three times this has happened in my life particularly. I’ve developed a real distrust of baby boomer women in groups – they seem to often circle the wagons and cut me from the herd, instinctively.
I didn’t get the memo, and I spent most of the time I would have learned all this doubtlessly useful social strategy keeping myself from getting raped or starved too often. I am smart and successful, and I hate being pitied or condescended to, so I don’t show my vulnerabilities often. This means that people probably think I’m thicker skinned, a lot thicker skinned, than I in fact am.
My wife had a good insight about the endless meetings this group has. I can hold it together for an hour or two of meetings, without saying something overly blunt or trying to hurry things along and get stuff done, but after that all bets are off. This group had collective meetings of 10 hours long, with meal breaks, but still. I’m too sensitive, emotionally and psychically, to hold it together and not say something blunt, when awash in all kinds of social ambiguity and murkiness for so long. I don’t really even understand what I’m doing, only that alpha women in groups really don’t like me. I was going to say women over about 60 years of age, but that’s not always so, it’s more like women who feel entitled to dominate by virtue of some status deriving from something other than role, competence or service, like age, or length of time with the organization or position in some invisible (to me) ruling oligarchy. I just don’t recognize those types of statuses, and don’t really want to. People often tell me, after we’ve become friends, that at first they found me intimidating. These women are usually women I have come to respect, or who seem older or more knowledgeable, so I’m usually surprised to hear it, although I’ve gotten used to it. I think my persona is a lot more amazonian than how I feel inside.
Blah blah blah. I’m sorry to be navel gazing to this degree at almost two in the morning, but I really am sore and stiff from being distrusted and shunned by yet another group of women. It’s not like I don’t have lots of friends, I do, it’s just this group of women in power thing that seems to trip me up. I have come to think of it as them being threatened, and trying to exclude me or put me ‘in my place’ but honestly I’m at a loss here. I’m sure there are some sort of mommy issues attached, I certainly don’t respect or defer to my mother, and for good reason.
I chose this picture, called Baxter and the Birds, because that’s how I feel sometime, like I’m a pretty straightforward dog, unable to speak the language of birds. Or perhaps I’m a cat in a pack of dogs, or a dog in a pride of cats. Baxter is having fun, which I sometimes do hanging out with groups of women, but it does capture the different species thing. If I didn’t know I was a woman, I’d swear I was a man. My wife says I’m like a man sometimes. I don’t really get the trans thing, not that I don’t think people don’t have a right to self-identify, but because, honestly if someone plunked me down in a man’s body, I’d get on with being a man. I’d probably feel no more out of place than I do now, and except for the systemic sexism and the fact that I was raped by a man for the first time at the age of five, I’m quite happy being a woman.
So today I had my lung function tested and it’s apparently just fine. The respirologist said the dizziness was just exercising too hard while being out of shape, as the lactic acid builds up in the body and gets released or something when you exercise hard, making one dizzy and nauseous. I guess I have to work up gradually or read up on lactic acid.
I did okay going to the doctor, but woke up at 4:30 this morning out of anxiety about it and couldn’t get back to sleep, so I’m running on fumes now. At least I seem to be able to go to the doctor. I handled it by bringing my wife along and promising to take her to brunch afterward. If he was arrogant and condescending I would order waffles with strawberries and cream. He didn’t turn out to be particularly condescending but I ordered it anyhow. He even had to press around my throat at one point and I coped with that fine.
What was valuable about the whole thing was that I got a chance to ask about my chronic cough/sore throat and got a couple of strategies to help it. It’s not a big deal generally, but it does seem to mess with my singing endurance a bit. The asthma educator woman I spoke to said that I might try taking a silent break for a few days to let my throat muscles relax and calm down, as they might be twitchy because of some past issues (irritation from chronic nose runnyness, which is now fixed, but went on for years).
Basically my asthma is almost completely in remission, given that I’m mostly avoiding what triggers it. Also, apparently I’ve been doing everything right, even to the extent of taking vitamin D supplements, which are supposed to be good for the lungs. At least something works.
I had my first singing lesson and actually it went pretty well. The teacher said I had a clear tone and a large range, and I had lots of great overtones in my voice. I sang with so much resonance in my head that my ears tickled and my sinuses started to clear!
You know, it’s weird. In the aftermath of finding confirmation my vagina had been injured by the rapes, it’s actually empowered me to do something about the physical discomfort I’ve had on and off for a long time.
It’s quite different to look at the pain as discomfort coming from an injury, than to think of it as some sort of nebulous survivor thing, or something that I can’t do anything about. It gives me something to look for for practical help.
I’ve been reading up about vulvodynia (pain in the vulva) online, and even though my nurse practitioner wasn’t very helpful, I’ve found some self-management strategies that seem to be working. I’ve discovered that the pattern of my symptoms and what causes them fits what other women describe. For example, some women feel sore during penetrative sex, but many feel sore a day afterwards when inflammation sets in.
I’m going to list them here in case any other survivors with injured vulvas find them helpful.
In order of helpfulness
VERY helpful: A squeeze bottle to rinse irritated tissues after peeing. This is so simple and so helpful. Thanks to the gal who runs the interstitial cystitis network for this tip. Instant pain reduction. Perhaps the vascular damage or scar tissue has made the area around my urethra more sensitive. I suppose a bidet would be even better, but I don’t have one. This works great. Just plain room temperature or warm water.
Massage. Yes, I mean massage, consciously loosening up all the muscles in the pelvis and vulva. Thank goodness I have a willing wife. It’s not foreplay per see, but certainly seems to make sex more possible. One massage got me pain free for almost a week. Apparently one of the proposed causes of vulvadynia is restricted blood flow in the vulva caused by clenching the muscles. I think that’s really possible as a cause for what’s going on with me.
Just a regular quite soft pillow on my work chair seems to help even better than the donut.
Sitting is bad for the vulva, apparently, and what do I do for hours each day? Sit in a computer chair. I’m trying to sort out my options on that one.
Donut pillow – This is one of those rubber blow up pillows sold at drug stores called an ‘invalid pillow’. It’s sort of helpful, but puts a lot of pressure on your legs if you’re going to be sitting for a long time. Apparently there are these foam pillows with a cut out or much softer strip down the center that are supposed to be good as well.
Thinking about relaxing my vulva and pelvis while I’m walking or resting. Seems to help a bit. I notice I do seem to clench up a lot of the time, now that I’m paying attention. Interesting.
There were also some tips about sex when you have a touchy vulva that looked helpful too: http://www.ic-network.com/selfhelp/sex.html I don’t know if I have interstitial cystitis, but since many women with it also have vulvadynia too, a lot of the tips cross over. I know I had a lot of bladder infections as a young woman, and I recall recurrent pain and needing to pee but not being able to as a child which probably was a bladder infection then. If I feel one coming on now, I drink a lot of water and eat a lot of vitamin c which usually settles it.
Since the physical things are helping, I don’t think this is a body memory, although the clenching that’s causing it might be. However, I’m not feeling much emotional energy around it, so I think it might actually be mostly physical.
For the first time in a long time I’m actually hopeful I’ll have a sex life again. It sucks to know that every time you have even gentle sex you’re going to be sore for days afterwards. Kind of makes it hard to feel it’s worth it, you know? I’m hopeful that if I can find a way to manage it I won’t have to.
It also feels quite weird to be talking about my vagina and vulva, present day, on this blog. “What kind of person discusses her vulva online?” some voice in my head says. Some people I know face to face sometimes follow my blog and I wonder about judgment about my poor taste in talking about my peach. However, my poor little raw vaginal vestibule (see I learned a new term, its the area just outside the vagina entrance) is pretty darn sore a lot of the time, despite almost never having sex and I think other survivors might be having similar issues, so I think it’s worth talking about, despite the embarrassment. I mean half the population has a vulva, and most of the rest of the world (save gay men, of course) are at least moderately interested in vulvae (my spellcheck rejected vulvas, and suggested vulvae, which sounds so literate) so I think it’s just cultural bullshit that it’s a taboo topic. Incest and vaginas and vulvae, oh my!
Vulvodynia is a medical term for having persistent pain in your vulva that isn’t explained by the usual causes.
You know what is so wierd? I just had gotten so used to the burning, itching and periodic pain, that I thought it was relatively normal. I’d gotten used to having to have sex in very limited ways and to feeling pain after and sometimes during. At times it hasn’t really seemed worth it. No wonder my sex life has fizzled.
Vulvodynia comes in two types. The first is where the woman experiences pain with intercourse, or inserting a tampon or similar, and afterwards, but not the rest of the time. The second kind is when the woman has the first kind of pain, sometimes not as severely, but also a persistent pain or itching at other times.
That’s the kind I have, and now that I know what it is, I can access the wisdom of women all over the world who have it too. Unlike the pain I had as a child, I’m not alone.
I found a list of things that are thought to be involved in vulvodynia and things that make it better and worse and I’m trying them. It’s actually helping.
One of the things that doctors believed about vulvodynia was that it is psychosomatic, caused by being a sexual abuse survivor. I think that’s demeaning. Of course there are physical effects of being raped, I’ve got the scars to prove it. And of course there are psychological effects that affect how the vagina and vulva feel and perform, particularly in how relaxed and open we feel.
What is demeaning and insulting to the brave women warriors who have survived rape as children is to dismiss our complaints as if because we know the cause it doesn’t need to be cured, like it’s some kind of hopeless case to have a vulva that feels healthy and good, and it is some kind of hopeless case to have a healthy mind and spirit after being ‘damaged’. It’s like we’re in some feudal culture and we’ve been ‘ruined’ by losing our virginity in an unsanctioned way.
I went to see my nurse practitioner, the one who showed me my rape scars last summer. I wasn’t there specifically about my vagina, but after she looked into what I was there about I asked her about the pain and itching. She told me all her tests had been negative for infection, that everything looked fine. I said “you think this is psychosomatic?” She didn’t say yes, but she didn’t say no. She said “we’ll you’ve had a hard life”. I said, I had a hard childhood, I’ve had a pretty good life, for the last 20 years, actually”. I hate it when people assume I’m some kind of lifelong victim. I’ve never been in an abusive relationship as an adult, I’ve never done drugs or abused alcohol, I’ve not been raped or beaten as an adult and I’ve made good choices for myself.
After I got home from my appointment I did some research. Vulvodynia is thought to be caused by chronic tightening of the muscles of the vagina, which restricts blood flow, causing the pain and itching. There are of course other theories, but I like this one. It looks like everyone wins – psychological: clenching of the vaginal and vulval muscles – physical: restricted blood flow causing persistent pain.
So what part of this allows her to dismiss my valid medical issue?
I’ll tell you what does. Her discomfort with having to help someone who was raped as a tiny child having persistent pain her whole life as a result. In her vagina. People don’t want to think about it. They want me to be crazy. They want it to be something they can discount. It makes it less scary for them. That a man can rape a child and get away with creates enormous cognitive dissonance for people. It’s nothing that should happen. It’s nothing he should get away with. I agree. But rather than trying to ignore or brush away the effects, I want to resolve them. I’m one of the sanest people I know. I know how to face reality in ways they don’t.
My wife and I are coming up on our ten year anniversary. I joke that it’s actually 40 years in ‘het years’ – kind of like dog years. Because lesbian relationships get little social support, a ten year anniversary is the equivalent of 40 years for a straight couple who have had help and approval from their culture from the beginning, going back as far as high school. How does this apply?
Life is a lot harder without social support. By shunning survivors of abuse, in all the ways our culture shuns us, we inhibit and restrict the healing and change that is necessary to make child rape obsolete. My ally, my nurse practitioner, well meaning and educated, does it, I’ve had a lover tell me, upon looking at a cute picture of myself as a child that “no wonder my father loved me so much”. I broke up with him soon after. It’s not love. I’m not a victim. Let’s just fix the problem, shall we?
So I’m working on relaxing those muscles, in various ways, on my own and with a little help from my wife. It’s working.
I haven’t seen my therapist in about a month and will be seeing her this afternoon. I’ve been seeing her for about a year, first weekly then biweekly, since soon after I found out about my dad/abuser’s cancer recurrence and had a strong emotional reaction.
She’s pretty good and I like her and I fairly often do some deep work with her, which is usually a good sign. However, I started healing 20 years ago. (I haven’t been in therapy that whole time, and there’s been several long breaks, including one of at least 12 years in there), and I’d like to have an idea of what it is I’m trying to get accomplished, so I can get it done. I don’t want to be spending so much money on this. My older brother’s voice echoes in my head. What a jerk he is, like he’s any more healed than I am if he’s reacting so strongly to me.
I’m thinking of tapering off to about once a month, or quitting completely and putting the money into say, a reiki session or massage once a week instead. Part of me suspects that this is just me feeling abandoned that she took a few weeks off over Christmas and so feeling a bit betrayed and dumping her. I had a hard Christmas this year, harder than I expected and I needed her. I had some mother grief going on. My mom sent me a card with a cheque saying ‘it’s been so long, I hope we can get together soon’ as if nothing had happened and it should have all blown over. I just want a damn letter from her saying something real. My therapist said I could call her if I needed to, but really I’d never do that unless my father died or something equally major.
I saw my younger brother just before Christmas, which was nice, but I’m pretty sure he’s mad at me for not giving gifts to my mother this year or seeing her, which increases the care-taking burden on him. (I did a donation to the food bank and a local group that helps incest survivors in lieu of gifts to family) I was planning to give him a gift, but he didn’t come by as expected to exchange them. I expect he may be taking her side. He doesn’t know about my finding the scar tissue. There’s no easy way to tell your brother that your vagina got ripped as a child by your father and that your mother would have to be extremely negligent to never notice a serious wound like that in a daughter she bathed regularly. Bullshit she didn’t know.
Over the holidays I woke up from a dream where I had birthed a baby on my own and had been nursing her. The nursing sensation was so real-seeming that it made me wonder if it was a memory. I suppose it’s possible I could have birthed a baby and not remember somehow if the dissociation was severe enough. I remembered in my medical report from that exam I had (that I wrote about in this blog) that my ‘os’ was tight, which according to the internet means I’ve never had a pregnancy, so that settles it. The rips were not from childbearing, they were from being raped when I was tiny. How crazy is post traumatic memory that I can’t even know for certain without checking that I’ve never been pregnant? How good of my practitioner to write that in my chart for me as confirmation and then send me a copy.
I’m nervous about my first session at the fitness club I signed up for. I go for my orientation tomorrow after work. They do a kind of boxing circuit training, and I’m worried I’ll end up crying. I may just tell the trainer that I was attacked so I may get emotional while exercising, and would she do me a favour and please just ignore it? I’ll see how she is and how I feel.
I started taking passionflower, which is an herbal antianxiety thing that Dr Oz, the tv doctor from Oprah said had been shown to be as effective as prescription antianxiety meds. I took it before going to a stressful meeting yesterday, and I think it actually helped. I don’t feel particularly sedated, which is good, but perhaps a little more sleepy. I’m not taking it today, and am ambivalent about the whole thing, but I thought maybe if the anxiety didn’t get in my way so much I could do some of the things I want to like singing and taking lessons and such,a nd then when I was used to doing them, I wouldn’t be so anxious.
I feel teary, which I often do on a day that therapy is scheduled, and was a bit yesterday too. It could be a bit of a hangover from the meeting yesterday. Intense people-stuff does tend to fry my circuits a bit, which I understand as being part of being a bit more sensitive than regular folks
Anyhow, I feel a bit guilty not writing the more interesting and inspiring stuff I used to write, but honestly, I don’t have it in me right now. May that change.
I’ve had pain and itching in my vulva for most of my life. I’ve worn out holes in the fronts of underwear from scratching. This, I’ve found through some recent reading, is actually pretty common with vaginal injuries like mine.
This summer, when I found out about the two tear scars and vascular damage, it all began to make sense. The medical professional that saw me suggested I ice my vulva when I was feeling pain or discomfort. Well she said something cool, and I’m using a well wrapped ice pack.
It works. It actually works and I don’t have to dissociate from that part of my body any more.
The pain happens without warning, and I’ve gotten accustomed to ignoring it. But now I have something to do about it, something that works.
So tonight I’m sitting on an ice pack, watching TV.
May you rot in hell, Dad.
This, as my friend Butterfly would say, is why you shouldn’t fuck kids.
In therapy today I talked about how I’m still trying to integrate the scars I saw into my body image. It’s not like it’s a big change, I realize. I always felt there was something ‘wrong’ with my vagina/vulva and now I know.
My assignments out of therapy are threefold. First, to think about what kind of ceremony or blessing I would/could do for a six year old girl who had been raped, and think about whether I want to do that for myself. Second, to sit with the rage that’s coming up toward my father, my mother and all the adults who failed to notice a little girl with a torn and bleeding vagina. Third, to write the story of the scar.
I’m going to start with number three, piecing what I know together in time order, filling in what I can in a narrative. This might be triggering for some people, so look after yourself. I can’t think of a picture to go with this, other than the one in my mind. In my mind I’m looking at the scars on my vulva.
My name is Kelly. I live in a brown duplex on my street. I have long blonde hair and am tall for my age. I like to sing and make up little songs. I have a dog named Tony who is big and black, and who likes to pull me on my crazy carpet in the winter. He’s very strong. I live with my mommy and daddy and my big brother. My brother is okay, although he mostly just does dumb boy stuff and doesn’t like to play with me. I can ride a bicycle with training wheels. My dad gets mad at my mom and sometimes he has a sleep on the kitchen floor. Our house has black and white shag carpet and book shelves my daddy made and a red phone in the kitchen up high on the wall. There is a tree out front that has dangly things that make stars when you crumble them. I put the stars on top of my mud pies, for sprinkles. Next door is Reo, she’s really nice and sometimes we get rhubarb from her garden and dip it into sugar and eat it, and sometimes her mom lets us eat rasberries. Her mom is really old. My mom’s friend Mrs H lives a few doors down and we go over there sometimes. I don’t like the H’s house because they smoke too much and the air is yucky. I play a bit in the carport in the front and sometimes we have garage sales there or I do a lemonade stand. Our house has a basement with a playroom, but I don’t want to talk about that.
I have a sore on my bum, near where I go pee pee. It hurts and burns and I feel like I have to pee, but when I go to the bathroom I just sit and hurt instead.
I’m dead. I know I’m dead because I stopped living. Last night my daddy pressed me down and hurt me and then I stopped living. When you die, it hurts a lot and then you go to sleep and don’t wake up, right? Well that’s what happened. It hurt so much. His eyes were big and stared and his lips were big and red. He smelled like beer. He was squishing my neck and I couldn’t breathe, like being tickled too much when you get dizzy and then I got more dizzy and everything went far away. Today I’m walking around but I didn’t wake up, so I know I’m dead.
When people die, everyone is supposed to come over and say nice things and cry, aren’t they? Nobody seems to care I’m dead. I guess nobody cares anyhow. My daddy isn’t home today, and I don’t like him any more. He smells bad and he killed me.
My name is Kelly. I live in a house now. I have my own bedroom. I don’t really remember being dead. My mom says I’m an absent minded professor. I read a lot of books really fast and I stay in my room. Sometimes I can’t hear it when people talk to me, even if they’re right next to me and talking really loud. My dad is an alcoholic. My mom says so. He comes home and we can’t have dinner, no matter how hungry we are, until he has a few beers and relaxes. Then we can eat. Sometimes there isn’t any food in the house and this is the only time we eat anything. When we have no money because someone hasn’t paid my dad yet, we go to a restaurant and my dad has some beer and we get to eat. When he gets drunk he goes to sleep in his chair and then it’s good for awhile. My mom and brothers and I talk, not too loud and we get to watch whatever we want on TV.
I can’t get to sleep very well. My mom makes me go to bed but then there are scary things, like spots that float in front of my eyes, or the things that might grab my leg from under the bed. Or the things behind me. Sometimes I put my head under the covers so they can’t get me but then it gets hot so I put my nose out. I can hear the clothes dryer sound going round while I wait. My mom says I’m too old to be afraid of monsters. My mom says “I’m right hear down the hall”, but it doesn’t help.
It’s really late and I’m still not sleeping. The dryer has stopped. I hear my dad’s chair in the family room as he wakes up. Sometimes he turns on the tv again and watches for awhile. Sometimes he gets up to go to bed. I hear his hands on the walls as he comes down the hallway. I can see the white around the edge of my bedroom door, which is open a little. He slows down. My heart starts to beat faster. He goes into the bathroom and closes the door. He clears his throat and spits into the sink. He does this because he smokes. I’m worried he will get cancer and die. He turns on the fan. I hear the pee going into the toilet and he flushes it. He washes his hands. A monster comes out and comes across the hall into my room. My mom is just down the hall. She doesn’t do anything. When he’s done he goes the rest of the way down the hall and climbs into bed with my mother. I can hear the springs creak.
I’m afraid of the bathroom. Sometimes when I’m in there my brother will reach in, turn the fan on and the light off, and then lock the door from the outside. I scream and scream and eventually my mother makes him let me out.
When I come home from school sometimes I lie on the couch in the living room and look at the carmel-coloured leather. My mind goes away and my body goes very still. I can lie like that for hours. It’s hard to move or get up. It’s like I’m dead.
My name is Kelly. I am having sex for the first time with my second college boyfriend. I can’t open up and he can’t get in. I can open up a little when I think about the hunting knife we had at my parent’s house, that has a little leather scabbard to hold it. The knife is sharp but it fits the scabbard so it doesn’t cut it. This makes me feel better. I tell him about it and he says “why not just think about a penis and a vagina?”
I’m not sure what the big deal is about sex. Kissing was way better. He wants to have sex all the time and I am seeing monsters. The monsters hide in the corner of my room and if I pay attention to them, they come closer. I tell my friend about the monsters and she has them too. She thinks that they are evil spirits come to attack us. Her boyfriend has ideas about how to keep them away. He wants to protect her. I tell my boyfriend about the monsters. He goes and talks to a psychiatrist at student health and they make me an appointment. The psychiatrist says I don’t have schizophrenia, which I didn’t think I did. She asks if I was sexually abused. I don’t know what she means. I tell her I may have been abused by a babysitter, but she doesn’t seem interested. She says I’m not ready to have sex yet. I tell her I don’t want to have sex, and lie and tell her I can avoid having sex with my boyfriend. When I break up with my boyfriend I go off birth control and tell myself I’m never having sex again.
My name isn’t Kelly any more. I’m in my doctors office. I have a sore vagina. The wrinkles in the condoms rub against me and hurt and afterward it hurts for days. I think I must have a yeast infection all the time, it’s so sore. I ask my doctor what to do and she takes a swab and gives me a prescription for some yeast medicine. It doesn’t really work. A few days after the treatment is finished I feel sore again. I think maybe I’m getting the infection again from my boyfriend but he won’t get treated. I go back to my doctor and she asks me a bunch of questions. She does some tests to see if I have AIDS or diabetes, since they sometimes cause women to have yeast infections a lot. I don’t have iether. I tell her I am a sexual abuse survivor. She looks very uncomfortable and tells me with a nervous edge “it looked fine”.
My name hasn’t been Kelly for a very long time. I’m sitting on the examination table looking at the mirror. The nurse shows me a little nub of flesh near the opening of my vagina. I know this nub by feel. It gets sore all the time, because it gets rubbed. I never thought about what it was before, except maybe a leftover piece of hymen. She says “this looks like your vagina was ripped a long time ago and healed without being stitched up properly”. I look again at the nub and the white line leading up to it. She puts her gloved finders above my vagina, near my labia. The skin there is a dark purple. I’ve never seen it before. She says, it’s unusually hot here. The veins look unusually swollen and damaged. This speaks to me of some old vascular damage that would have happened when you were abused. I tell her I’ve never given birth or had any kind of rough sex that would cause damage. She says, “this looks like this is really old scarring.” I hold my wife’s hand and close my eyes. A wave of tears flow through my body but only a couple seep out my eyes. I tell her I’m ready to go on.