Hi, I am "Ms X" in Dr. Noor Gajraj's article on Botox for the treatment of PNE. He was a professor at Southwestern Medical School in Dallas, where my son went to medical school. This was a participation in Peter Jennings of the national news "Pain Week, USA". I had surgery by Prof. Robert in Nantes, Fr, which was not successful. Dr. HIbner of Phoenix redid the surgery (the old way for both); I will be having PNE surgery this next year since Hibner can use a scope to reach the entrapped area in the Alcock Canal. The way I survived was the botox injections which calmed down the spasms, usually every 2-3 months apart. I do not have control of the bladder and have diarrhea without it. I go from constipation to diarrhea when I go without it. Simenthecone (OTC) and Bentyl help deal with the intestinal problems. Hopkins is an excellent place to get help and you are lucky to be near it. Very lucky. Plane tickets and motel rooms are expenisive at best. Botox makes it bearable until your doctor decides what to do in your case. I still sit on a pillow and cannot stand hard surfaces at all. Walking is excellent treatment as is Physical Therapy - Womens in keeping you together. The PT I have has a masters in womens physical therapy - she works in the vaginal canal and the rectum to stretch it out some. Leah Tobey trained under Loretta, Dr. HIbner's physical therapist. Recommend both. It works so you do not have to have the piles of medication which will bind up the intestines. Miralax and flax seed (OTC) will help you control intestine issues which affect us. I buy the MIralax and simenthecone at Dollar General under their label, and Flax seed is available at a grocery store. I am on Tylenol for pain control, no blood thinners allowed. I sleep on a beanie bag (heated in the microwave for two minutes) to relax the muscles. I wish you the best in dealing with these symptoms.