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.