Originally Posted by EdzMommy
Dear Storm Bride:
I'm sorry that you had such horrible experiences with your anesthetic care. It's not fair to group all medical professionals into the "paternalistic, selfish" category. There are certain standards of care that I must maintain. They are established by the American Board of Anesthesiology, the American Society of Anesthesiologists, and Society for OB Anesthesia. These guidelines and standards are based on decades of scientific research and observation. And when patients sue, these are the standards that care is compared to in court. Its not fair to ask me to compromise quality of care and put me in an uneasy situation that could possibly compromise your and your baby's health.
I never said medpros are selfish. I said they're paternalistic. Whether or not what I said applies to all of you, at least get what I said right if you want to argue the point. I also wouldn't sue a doctor, except in circumstances of extreme negligence (eg. showing up in OR drunk). I think it's insane to expect doctors to be perfect at all times, because you're human, just like the rest of us.
I find it frustrating that you'd rather get IV pain meds in multiple doses that are systemically absorbed and get into breast milk, but you have such an issue with the neuraxial opiates that are given in such small doses. But, its your decision.
Frustrating? Why is it frustrating? You're frustrated that I want care that works for me?
ETA: The IV pain meds that I self-administered were taken later. By the time I was getting them, the stuff in the spinal would have already worn off, anyway. BTDT. So, I'd have been taking something else at that point, regardless of whethe or not I'd been through the post-op itching hell.
Informed consent is a two-way street...patients need to ask questions and be honest when giving the docs information. Lying about drug reactions could jeopardize your health and your unborn baby's health. Demerol has a ton of bad side effects, and most hospitals don't even have it on formulary anymore because of those side effects.
What are you talking about? I've never lied to a doctor about a drug reaction and I never would. I have no known drug allergies of any kind, and I've always said so. This has nothing to do with what I'm talking about. I'm not sure that it was Demerol - can't remember for sure, as it was two years ago, and I had a lot of other things on my mind.
I respect your autonomy and ability to make decisions for yourself. However, you seem very angry and argumentative and are more interested in your own agenda than having a true conversation with your anesthesiologist.
And, what do you base this on? Have you ever been there when I was talking to any of them? Holy crap. I post something on a message board, after my experiences with multiple anesthesiologists, and you decide how I've talked to said anesthesiologist based on it? My only "agenda", as you put it, is getting care that works for me. If that's imcompatible with your job, then I'm not the one who has the issue.
We're not just epidural jockeys or techs or bartenders. After 13 years of education post-high school, I consider myself an expert on anesthesiology. Do you scrutinize your car mechanic like this? Do you ask about which types of oil, coolant, hydraulic fluid that go into your car when you take it for an oil change? I have been a patient before and I understand the vulnerability that one feels when you have to relinquish control. Maybe the folks you interacted with were really old school...but its not fair to dictate the terms of your anesthesia. It bothers me that patients never seem to question the need to go for c-section, but want to tell me exactly how to do their anesthetic. You've painted me and my fellow anesthesiologists as drug pushing monsters looking to get our patients wasted. And it is far from the truth.
Never seem to question the need for a c-section?? Maybe you should find out who you're talking to before you spout off. I've been to hell and back trying to avoid c-sections. I don't believe any of mine were needed, except the one that didn't ultimately succeed. Spare me your assumptions.
"Scrutinize" my car mechanic? Ask what types of fluid? What are you talking about?? If a mechanic puts something in my car that makes the engine seize, does it again, and then tells me I need that again, then, yes - I'm going to "scrutiinze" him. You are completely missing the point. I trust my mechanic to do an oil change, if that's what I asked him to do. But, if I take my car in for an oil change, he's bloody well better ask me before he does any other work. The fact that I have no choice but to have anesthesia for surgery doesn't mean I have to accept pain killers, as well. I'm not talking about the anesthesia. I don't even ask any questions about what goes into that stuff, because I need to have the spinal for surgery, and I have no known drug reactions, so it's not relevant to me. I've even accepted that I can't request general, although I'd prefer it, because of the effects on me and the baby. I'm talking about post-op pain management, not anesthesia. And, yes - I have the right to "dictate" whether or not I want it!
I'm not painting anyone as a "drug pushing monster" and I've love to know where you get that.
We anesthesiologists have a huge responsibility to get our patients through surgery safely...and sometimes in emergencies we can't do a la carte care if it could injure you. Primum non nocere...first do no harm. It's part of the Hippocratic Oath.
Okay. So, what does geting me through surgery safely have to do with post-op pain relief, which is the only thing I'm addressing in my post? Your response comes across as though you haven't even read what I wrote, and you seem to have some really bizarre preconceived notions about what I was saying (ie. your simultaneously hysterically funny, yet infuriating comment about "patients never seem to question the need to go for c-section").
My c-sections, except the first one, and the fourth one (where my son died) were not emergencies. ANd, the two emergency ones were both done under general anesthesia. I realize that an emergency situation has special circumstances around it, but the "sometimes in emergencies" aspect of this doesn't apply to me at all. I had grotesque, show up at the hospital as if I'm getting my hair done, "births" with my 2nd, 3rd and 5th. There was lots of time to talk to the anesthesiologist, if they'd wanted to talk to me. (And, the guy who gave me the morphine stuff during my second one did tell me he was going to - but I didn't know about the side effects, and I was also not in very good shape to think, as I was just barely suppressing absolute panic. The next guy didn't ask - he just gave it to me. And, I didn't get it the last time, because I addressed that ahead of time.)
Your profession (and I don't just mean anesthesiology) has decided that pain=bad, so anything that takes away pain=good, whether the patient (ie. the person actually experiencing all this) agrees with you or not. I've had to accept spinal anesthesia, three times, as part of the hurdle of having children. It's been hellish. It's roughly as awful an experience as the surgery itself. And, that has NOTHING to do with what I was talking about - which is giving me post-op pain relief (NOT surgical anesthesia) that I don't want, without my knowledge or consent.
I don't really have a big beef with anesthesiologists. As far as medical professionals go, your specialty is better than average, imo (although I understand you're the ones ultimately responsible for the insane "nothing by mouth" labour guidelines).