My funky back meets the genius anaesthitist

This post is going to get a bit medical so if that does not float your boat then don’t feel you have to read just because you normally follow my blog. I just want to write about it for the record and for that handful of people in the world that need to know this stuff for their own personal reasons. 

Background

Ok so in 1991 when I was 14 years old I was a dumb dumb who got into the car of my boyfriend (along with my best friend and her boyfriend) even though I was forbidden to by my mum, and lo and behold the dummy loses control of it and slams it into a telegraph pole.

It was back before all cars had retractable seatbelts in the back (girls in back, boys in front apparently) and my adjustable seatbelt wasn’t adjusted to be tight for me. So it fell down my shoulder in the crash and flicked forward in a way that gave me a bunch of crazy injuries including a fracture of the T12/L1 vertebrae in my spine. As my internal injuries were of more pressing importance my back was basically left alone to heal on its own. I was just had to lay flat on my back and not move which was pretty easy in the early days as I was quite out of it.

It is quite amazing what the body will do for itself when it has to. My back actually healed quite well by itself. I don’t have ongoing pain and I can exercise, including something high impact like running, with no problem at all. It does look unsightly though. Basically it kinda mushed itself into a triangle shape vertebra and because there was nothing in there to keep it straight it healed with a curvature that protrudes from my back. You can see if if I’m in a swimsuit but  on a day to day basis you’d never know. I don’t hunch when I walk as I’ve been pedantic about posture and my hair is long and covers it quite a bit. Plus I tend to know the right clothes to wear to cover it most of the time. If people see a lump there they usually think I’ve got a buckled bra strap or something. Anyway, very lucky girl and not that big of a deal in the grand scheme of things.

Fast forward 20 years and I am pregnant with my first child. I actually had a pretty good pregnancy despite the back. There was about a 4 week period from 28-32 weeks where I had a lot of trouble with the muscles around the break (I think they are normally underutilised and all of a sudden with a baby too it was tough on them) but then bub dropped a bit and the pressure was off and there were no problems for the remainder of the pregnancy.

I tried to be really prepared for the birth as I knew there could be complications for an epidural or spinal which I would need if I needed a c-section. I told the hospital about it during my regular appointments, they referred me to the anesthetist and she said that she felt an epidural potentially wouldn’t work but a spinal probably would – basically as they work a little differently in terms of delivery of the medication (more on that later). Anyway seeing her didn’t help me. I birthed in a different hospital in the end and no one cared about the paperwork on file because public system and the whole thing was disregarded.

The birth

I was induced due to a fluid leak and low fluid levels which I did not respond to very well (read: SLOW).  In an effort to be prepared I took my x-rays with me to the hospital and tried to get a chin wag with the anesthetist working that day but he/she was too busy and never showed up.

After I went from only 3 cms to 4 cms after 8 hours of contractions and they told me I couldn’t have a second shot of morphine I was almost crying with disappointment so I asked for an epidural. The anesthetist finally came and checked it all out and proceeded to try and talk me out of it – told me I was higher risk for something to go wrong (ie the hideous headaches you can get) because they couldn’t be sure about getting a correct insertion. He left us to discuss and we decided no, that I wouldn’t do it.

Five mins later he comes back in and tries to talk us into it after all. The logic being that basically I was progressing so slowly that it was going to be a very very long birth on the induction drip which is pretty awful and they just didn’t think the other drugs would cut it for me. So we agreed. And the fucker failed. I got incredibly numb in the feet and lower legs but the pelvis area was still as painful as ever. Disaster as now that meant that I couldn’t move at all but I was still in pain and oh, they wanted me to resort to the crappy drugs which they’d just told me wouldn’t be good enough.

Apparently he got a “text book” insertion so he says it wasn’t him and I didn’t end up with the headaches so happy days there. Essentially it was decided that I probably had some scar tissue in the region from my injury and that was preventing the epidural from being 100% effective. Fast forward 13 hours and I was still in labour (now 8 cms) but now I had an infection and things weren’t great so they finally decided to take me for a c-section. I was so relieved. I just wanted it all to end by that point. Anyway because they couldn’t numb me from the waist down I had to be put to sleep with a general anesthetic which means I wasn’t awake for the birth of my baby. Small price to pay for a healthy baby, absolutely, but it would have been nice to be awake for it. Hence the need to investigate options again this time.

I did ask about trying a spinal instead as that had been recommended to me but this particular anesthetist didn’t believe it would have a different result so it was never attempted. End of story.

The suggested plan for this birth

I really liked the anesthetist I saw yesterday. My OB loves him (calls him things like brilliant and a genius) and he is an older guy so very experienced. He would have seen a lot of different scenarios in his time. He agreed with the first anesthetist I saw that a spinal block might have a better chance of success. A spinal block needle is actually inserted further into the spinal cavity. The drugs are injected into the spinal fluid surrounding the cord although the cord itself doesn’t travel that far down the spine. On the other hand, the epidural is  injected into the epidural space which is the space before the spinal fluid where some nerves branch out. It works by infiltrating those particular nerves and it is though that maybe my nerves in that area might be a bit thick due to the trauma they have experienced.

Here are some pretty pictures to help you understand if you are a nerd like me.

He said that he would write a letter with his recommendations that I am take with me with my x-rays when I attend for the birth however he cannot guarantee that another anesthetist will feel the same way that he does. He estimates that perhaps 1 in 10 anesthetists would actually feel that a spinal is too high risk for me (the additional fluid in the region could cause more trauma to the existing injury and have a long term adverse impact) but he doesn’t feel that it is a high risk.

THAT part freaked me out. It made me wonder if I should really doing it even if the risk is low. I don’t want a lifetime injury. Far out. Freaky. He did also say that I could try an epi again and maybe it would work if I wanted the pain relief during labour but really, I don’t want to do that again. If it doesn’t work I end up imobilised which is shit for birth so in my mind it just isn’t worth it.

Anyway I spoke to Eric about it and have done a bunch of research and we just decided it is something I am going to have to make a call on on the day. Hopefully the baby will be perfectly positioned and I will be fit and prepared with my amazing doula there to help me along and into an incredible natural birth. This is what I want to happen and this is what I truly believe will happen.

It is funny as the reason I did all this back prep last time was because I felt sure I was going to need it and I did. Whereas I’m going through the motions again this time because I feel like I should but something is telling me that I’m not going to need it. I hope my instincts are right! Although I’m certainly not looking forward to feeling that “ring of fire” that I’ve heard about. Eeeeeep!

Now if you’ve made it this far then well done! If you have any questions I will do my best to answer them. Just leave a comment below.

 

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35 thoughts on “My funky back meets the genius anaesthitist

  1. So, as you know I was in a very similar situation. I have spina bifida at T12, L1 and L2, along with a fracture at L5. Any type of spinal is way too dangerous for me, but I was able to find enough relief with a morphine drip (even on 12+ hours with pitocin and an infection). The other option is fentynl (sp?) which helps some as well. Have you considered laboring in water? You can always get out when it is time to push.

    Either way, you are right and it is a decision that you will have to make that day.

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    • Yes I am keen to try the water thing but not sure if the hospital will let me. I was looking at the book-in form the other day and it says I can’t have a water birth if I’ve had a previous c-section (which I have). I need to ask them why and if this also means I can’t labour in water. I did have the morphine drip last time and it did not work for me AT ALL but I think the whole pain relief issue had a lot to do with where they put my mind by telling me the other stuff wouldn’t cut it. Thx for the input! It is quite fascinating that we have similar stuff going on in the back dept.

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  2. Gosh, that accident sounds so scary! Was everyone else in the car ok? I hope you have the natural birth you want, too, but I am glad you did your research and will at least be going in armed with a letter from a good doc.

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    • Yeah it was pretty full on. I think I really had youth on my side. You don’t really understand how substantial things are when you are really young. I was the worst injured by far. The driver (my bf) had whiplash, the mate in the front left had a broken leg and my friend in the back right hand side had a really badly broken finger (I don’t think she could ever bend it properly again!) so I just got really unlucky on that one. That damn seatbelt!

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  3. With this stuff I like to get the raw data… with my research on statistics of risks associated with procedures like these is that they lump surgeries like back surgery in with labour/delivery… so an 80 year old lady might have had a migraine after back surgery and that goes into the statistics for spinal blocks, thus skewing the statistics for their use in labour. You can also ask your anesthesiologist if anything like that has happened in a procedure they personally have performed.
    And spontaneous labour might be something that you can handle? I didn’t get to experience that so am yet to find out also.

    Side note…how awesome that you are looking at it from a positive position! You don’t even sound scared…just prepared! Prepared not scared ha ha

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    • haha yeah I’m not so worried about the headaches as it’s not a long term impact although it would suck.And he was only saying more likely to occur because the way my back is curved makes it harder to do a correct insertion so I guess he just wanted to cover himself for a whoopsie. It’s more that if they inject that shit into my spinal fluid and my injury can’t cope with the additional pressure then I’m fucked. It could mean paralysis. But like I said, this guy has loads of experience and he seems to think it is very low risk. And yeah I agree, a spontaneous labour might be a very different experience for me. One can only hope 🙂 haha prepared not to be scared? lol I think things might be a little different on the day but I’m doing my best!!!

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  4. Thanks for posting this. Now I wish I had an MRI to see where all your vertebrae and your nerves and cord are. 🙂 Are you shooting for a labor without anything and then the spinal if you decide on that in the moment or if it’s needed? Birth is like one of those books where you never know the ending. There are multiple endings you can choose. Remember those books? Anyhow, I’m glad your safe, your back doesn’t hurt, and you have a beautiful baby girl waiting to show herself. –Terri

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    • haha I had an MRI on it years ago (like back when I had the injury) but I have no idea where those films are. I have an x-ray though that I could try photograph and send you? I am shooting for a vaginal birth and for me that means no spinal injections of any kind. I will try for drug free and hopefully the doula will be able to help with that but I am not ruling out other things. The difference this time is that I will try the other drugs incrementally – ie gas first and then something else blah blah. That isn’t how it happened last time. The spinal research is purely for what if we need a c-section scenario. My doula also has a TENS machine which I know some women really like so hopefully that will help too. Ha I loved those books and birth sure is just like one of them. Such a good analogy!

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      • Oh, so, so, so much good energy for when that birth comes being sent your way. So much. Don’t worry about my curiosity with imaging. I’m insatiably curious about too many things that aren’t my business. 🙂 It’ll land me in trouble yet. You breathe and focus. Use all that breathing from the running you used to do to focus on. I am so excited for you! Monkey and sister. !!! 🙂

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  5. Having done both, I would do a natural again any day – as long as I’m not sick as a dog like I was when I went into labour with dd2! I have no idea whether the epi slowed things down or if it was delayed simply because she was stuck in the cord, but as long as things aren’t hung up, our bodies are so capable of regulating pain well. Your doula AND YOU will be great! Xx

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    • Yeah I have a lot of faith in the doula simply as it means more strategies. Last time our only strategy really was get through it. We had no focus. So I am going to give natural a red hot go for sure! There won’t be spinal anything if there is a vaginal birth. I’m not up for any of the risks unless we need to have a c-section. xx

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  6. I remember wanting a natural birth. Yeah, that was cray cray! But, I had been in labor 24 hours before they induced me, and crap, being induced hurts so much more than natural contractions! So, we tried little drugs to take the edge off… for almost 12 hours, then they decided that Mr. T was started to feel distress and he really wanted out of me, and my body just wasn’t capable of doing it, so I got the epidural, and oh my gosh, that was so wonderful… it didn’t take long before I went back for a c-section… but in recovery, I did get the epidural shakes! Apparently one of lesser side effects can be all over, uncontrollable shaking… that was fun :/, but once it was over, I was good to go!
    So, here is hoping that no matter what happens, it all happens smoothly and progresses very organically for you – mine wasn’t what I planned or expected, but it was wonderful, there was a flow and progression to it that gave me time to adjust – and that is the best thing I could wish for you! 🙂

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    • Yeah birth never seems to go to plan. You sound like you had such a looooooong birth experience. Talk about full on. You gave it a red hot go!!! I will be happy with however she comes out in the end as long as we are both healthy and safe. That’s all you can hope for. xx

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  7. I read the whole enchilada!!

    Seems like we’re both of the same mindset: neither of us knows how birth will go so we’re covering all our bases beforehand so we can go with the flow on the day of. Seems like a brilliant plan 🤓😎☺️😜🙂

    No matter what happens, I really hope you get your wish to see the little lady and hold her right after birth. I think that would be great, but, as you say: a healthy bub is all that matters!

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    • Nice work! Yes, we are definitely on the same brilliant plan. It is nice to feel like you have looked at all the options. And yes, I hope more than anything I get to see my baby girl arrive this time but of course, I will take a healthy mama, healthy baby however that needs to happen.

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  8. Fascinating and very scary. I have my fingers crossed that the labour and birth will go swimmingly, and that you’ll not have to make this decision and go all-natural! how’s that for positive thinking!

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  9. I learned something today – I thought a spinal was just another name for an epidural! It’s great to be prepared and your anaesthetist sounds very good. Fingers crossed you won’t need to worry about it on the day and it will all just flow beautifully x

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  10. Interesting post. I hope you’re able to have a successful vbac, but if not at least you’re prepared. Is there anyway you can get an anesthesist that you know at the birth or it’s all random?

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    • The only way to get one for sure is to have a booked c-section same way as to book them for any other op and I don’t really want to do that. So I guess if I wind up having to book for any reason (breach baby yada yada) then we would do it to sync up with this dude.

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  11. I hope you get the natural birth you’d like. It sounds like it would just make everything a lot less complicated….Although I found all of this to be super fascinating.
    I had natural, drug free births mostly due to a horrible phobia of needles and drug allergies. Also because the thought of numbness terrified me more than the pain.
    My second baby was 30 hours of labor and then I pushed for about 30 seconds, and what helped me the most was a doula and being in the water or shower.
    Talk to your doula and I;m sure she’ll be able to help you prep for (ideally) a natural birth….but it’s so awesome that you are a realist and are prepared for any outcome.
    I wish you all the best with this!!!

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