Tuesday, November 10, 2009

37 weeks, 37 minutes

37 weeks in another 29 minutes. Yay! Officially not having a premature baby!

So, remember how when Avtalyon was born, I posted something like, "The labor in brief: I am never doing this without drugs ever again"? I meant it, too. I did it without drugs twice. I am officially woman, hear me roar, yes, very nice, NOW GIVE ME THE GOOD DRUGS.

Unfortunately, it's not that easy.

Some of you know I had an incredibly awful experience with Barak. Part of the awfulness was five--count 'em, FIVE--failed epidurals. They slipped, they fell out, they never worked, and one time the lidocaine ran out but the alarm didn't go off and... yeah. Anyway. Epidurals and I do not have a good track record together. Part of the the problem appeared to be that I have scoliosis. I had a back brace for several years and while the curvature has mostly been corrected, some amount of spinal rotation is still there, and this of course presents a problem when someone is trying to, say, insert a needle into your spine in just exactly the right spot.

When I was in L & D a couple of weeks ago with the shingles, I started having a little bit of, ah, post-traumatic stress. As in, I said "I'm getting tense just being here" and, er, started to cry. My midwife, the next time I saw her, suggested I call the anesthesia department and get a consult. I did talk to someone, and it was a good, informative, open talk from a very nice anesthesiologist who told me openly that he couldn't give me an answer on whether an epidural would work for me until he tried. I tried to give him only the bare bones of what had happened and it made me feel better that he sounded completely horrified. He promised me that I would not get a resident (part of the problem last time) and also said he would only try once. "I would say that it should work but I can't make any promises, especially given what happened last time. I think you should talk about other options for pain control." So I did, on Friday, and you know... there aren't many and they aren't that great. Demerol, yeah, but it doesn't work that well and like any other drug the baby gets some of it if you have it in you for long enough. And hello, it's labor--things happen unexpectedly. My labor with Avtalyon really was ok until the last 37 minutes. I remember this, because I looked at the clock when I said I needed to push and he was born 37 minutes later and it was the intervening period of time that even I can't quite summon up the words to describe.

My midwife, when I said this to her, tried to make it positive. "I know it's awful, but even with Avtalyon it was only 37 minutes. You can get through it." Which... well, it sounded good at the time, but, sorry, no. As I said to my husband that evening while relaying the conversation, "It's like someone saying to you, I'm going to start hacking you apart with an ice pick now. But don't worry! I'll only do it for 37 minutes, and then I'll stop and it'll be all over!" Not so reassuring really.

There's nothing I can do really but just see how it goes. I'd like to try to get through it without attempting an epidural. Part of what was so hard about having Barak was that I had tried so hard not to have an epidural and when I finally agreed to one I already felt like I couldn't take it anymore, I was throwing in the towel and I needed it to just. stop. hurting. And then having it not work, multiple times, was more than I could stand--harder almost than not even trying. IV drugs, well... yeah. Also not an ideal option. But getting hacked apart with an ice pick isn't so awesome either. Even if it's only for 37 minutes.


Anonymous said...

So the "good" pediatrician is back now! Well done, hanging in there.

Hope the ice pick doesn't materialize, or else that baby-to-come makes it not so bad in retrospect... (Pity the docs can't give patients something to make them forget the awful pain, even if they can't take the pain away, isn't it? That's almost as good a solution.)

~ Jasmin

SuperM said...

Yeah for good pediatrician being back!

As far as pain goes, the opiods turned out to be good for me. I don't remember most of the pain, although I am told I experienced some at the time. On the other hand, my second and third didn't require a lot of pushing, possible to make up for what the first put me through. They're not telling.

Good luck, and I very much hope it all works out wonderfully, whatever you choose.

LC said...

One other suggestion - don't wait until it's so bad that you can't bear it.

(A) because then it's that much worse if the epi doesn't take nicely

(B) because apparently adrenaline can override the numbing effects of the medication - from my BIL the obstetric anesthesiologist, after the epi for kid #3 didn't take (I was apparently through the worst of transition already by the time they had someone available, but no one bothered to check me b/c it had been less than an hour)

(C) if they check you first and you're TOO close to pushing, they won't/can't do it, maybe related to (B).

Cyndy said...

Let your midwife/labor nurses know from the beginning that you want an epidural. LC is right...at a certain point it will be too late.

uberimma said...

Cyndy, the thing is that I think I would rather not even try an epidural than say, "I need an epidural" and then find out it's not going to work. I feel like since I know it's liable not to work, I can't go in there feeling like it's an option. So if I walk in saying, I'm going to want an epidural, and then I can't have one... I don't know, for me that's somehow worse than just accepting that I won't be able to have one right from the outset. Not sure if that makes sense, but these things often don't, I guess.

OneTiredEma said...

I agree that not knowing how it's going to go is completely the worst part.

AM was an attempted VBAC. My labor was long and hard until the last hour and a half, when I attempted to have an *unscheduled* C-section and had to wait for an OR. My epi had long worn off (I had tried to push for about 2 hrs) and I essentially had a 90 minute contraction while my OB and my husband discussed hockey. That? Wasn't fun. (The spinal in the OR was AMAZING though. Of course.)

Living with the uncertainty is just so rotten. I suggest a nice prenatal massage. At least you get to be really taken care of for a whole hour.

Cyndy said...

As an epidural flunkee myself, I do understand your thinking and the PTSD. Before my first emergency C-section the nurse brought me the consent form and offered to find my glasses. I just snapped and said, "I know what it says, just give me the $&*%#$!! pen!" At least I didn't work in that hospital.

Anonymous said...

BTW, epidural didn't work for me, either. I also waited quite a while to ask, so maybe that was it. When they were wheeling me into the OR for the C-section (baby too big, labor not progressing, back birth), I told the anaesthesiologist about this. "Don't worry," she said with a twinkle, "we have the good drugs." And they totally did. I was completely conscious and also entirely pain free for the first time in about 36 hours: didn't feel a thing below the neck. I absolutely understand why women name their children after their anaesthesiologist!

~ Jasmin