I am sorry to hear that you are suffering so much from PGAD. With all the things you have tried, it sure shows that you want to get better and you really want to be there for your family.
My PGAD started 4 years ago, but I have been symptom-free for over 2 years as long as I stick to my treatment plan (lyrica, PT, xylocaine ointment on vulvar area, deep breathing exercises, etc.)
My doctor sees PGAD as a chronic pain problem and treats it that way; the pudendal nerve is misfiring and sending unwanted arousal signals which are low-level pain. She says that she hasn't seen PGAD cases where it is the only problem that the patient presents, but usually there are symptoms like IC, irritable bowel,vulvodynia, vestibulodynia and/or uretheritis to name some of the most known. Essentially, her point of view is that PGAD is something that builds up over time (like decades). In my case I had a bad fall on my tailbone and had needed gynaecological surgery years ago; to her that indicated that it was a problem area for a long time. When I first saw her she diagnosed PGAD as well as bladder spasms and burning of the vulva (vulvodynia). Her approach is to treat hyperarousal signals in several ways as this misfiring is a sign that the spinal cord has rewired in an inappropriate way. The aim is to try to calm the irritated pudendal nerve and get things to rewire to the spine and the brain in a more manageable way... To make a long story shorter, from trial and error we found that I really needed to stick to medication like lyrica for the long-term for it to really help, also I needed to persist with deep breathing and other home exercises daily, regular PT; then nerve blocks started helping and we were able to add 5% xylocaine ointment to the vulva several times a day to numb that area (and confuse those unwanted arousal signals)... Until I met this doctor, I thought there was no hope for things to change, but I was wrong - it was a lot of work, but I have improved. Am I cured? Probably not, as I walk a fine line and I must follow my regime. BUT, THERE IS HOPE for things to improve.
Nobody said that life would be fair... I believe in God, but I don't think that He or She gave me this disorder; I was set up for a "perfect storm" with my various pelvic problems - something was going to happen. I do believe that in my darkest moments God has walked at my side, sad to see me suffering.
What else helped me get through this: swimming as the water made my symptoms unnoticeable, Full Catastrophe Living by Jon Kabat-Zinn and practising mindfulness meditation, supportive counselling, identifying triggers and using strategies to avoid them as much as possible, doing something for others as often as I could - even a small act of kindness for a neighbour, etc.
Lucy, for now can you find supportive people in your life that can help you with the kids? Is there someone you can talk to who is supportive and non-judgemental?
Sending you positive energies as you journey along.