Originally Posted by brovie
I think its important FOR EVERYONE ON THIS BOARD to remember that you and the anesthesiologist actually have the same goals and I don't see why we can't approach each other with a little less baggage and a little more respect (a little less paternalism on the doctor's side and a little more open-mindedness and trust on the mom's side):
- freedom from UNwanted pain (note: not ALL pain. this is patient determined...pain vs pain meds and side effects and is a different threshold for every person)
- the ability to mobilize (get out of bed, lift your infant and take care of your infant, walk to the washroom, etc) after surgery
- the ability to breastfeed if desired (requires both pain control and breastfeeding compatible meds)
I have my baggage, because of my experiences. Sorry if that doesn't suit you, but it's the way life works. It would make no sense at all for me to continue to trust doctors, as they have, by and large, repeatedly shown themselves to be undeserving of said trust. I had a good feeling about my last OB, and I'd trust her if I ever needed an OB again...but that doesn't mean that I'm just going to say "oh, okay - that one was good, so the various crap I've had from every other doctor I've seen in the course of my reproductive life doesn't count - doctors are obviously going to look out for me". Quite honestly, it would be completely illogical for me to do so.
My anesthesiologists (at least two of them) did not have the same goals as me. They didn't even know what my goals were. They assumed that I wanted the same things they did, and proceeded accordingly. The fact that they may have been right, if they'd made the same assumptions about most patients, doesn't mean they were right about me, or that we wanted the same thing. This kind of blanket "you and the doctor have the same goals" statement is one of the things that drives me batcrap crazy about the medical profession, as a whole.
Interestingly enough, my ability to mobilize after surgery was best with my last c-section (the one where I put "my agenda" ahead of the anesthesiologist's experise - apparently - by refusing any post-op pain meds, excpet those I dispensed for myself). And, increased mobility, because you can't feel pain, isn't all it's cracked up to be. While I've had pain after all my surgeries, even with the duramorph, the "pain management" did work reasonably well after I had ds2, which is how I ended up tearing a staple out of my incision, which then got infected, and didn't fully close for almost two months. I'd have done a lot better with less pain management, and a little less mobility, in that particular situation.
Why does breastfeeding post-op "require" pain meds? I've never needed meds for that.
And, re: "unwanted pain" being patient determined. I've never had a doctor (including an anesthesiologist), nurse or any other kind of care provider express any interest whatsoever in what level of pain was acceptable to me. They decided what was okay, and proceeded to attempt to "manage" my pain according to their own bias.
ETA: Before I leave, I wanted to add something about the mobilization thing. After my first, "emergency" c-section, I was badgered endlessly by doctors and nurses telling me to get up and walk, that they "know it hurts, dear, but you have to walk". Not one of them (there at least 10-15 medpros who talked to me about this in the three days it took me to be able to leave my bed for more than an assisted trip across the room to the bathroom) listened to a word I said. I repeatedly explained that the problem wasn't pain. It was weakness.
I hadn't eaten much while in labour, and nothing at all for at least 6-8 hours before I went to the hospital. I'd vomited when labour started, shortly after dinner. So, I had a c-section on Friday evening, and the last real meal I'd eaten was lunch on Thursday, with a small snack that afternoon, and then maybe a cup of fruit/veggies over the course of my 21 hour labour. Then, I'd been given all kinds of drugs in my IV (general anesthesia). Then, I was given morphine in post-op. Then, I was given a sleeping pill (which I'd have refused, but I was still too out of it from all the other drugs). Then, I wasn't allowed any solid food for another 3.5 days, while recovering from surgery, "childbirth", and all those medications. I simply couldn't walk. I could barely stand up (not long enough to change a diaper, for instance, even though I was clinging to the cart the bassinet was on). I was too weak. Not a single person I talked to believed me, and I was repeatedly castigated for, basically, caving to the pain. "I know it hurts, dear, but it's important." "It's going to hurt, but you have to do it." "I'm sorry it hurts, but walking is essential to your recovery." "You have to get moving, no matter how much it hurts." "You're still not walking? You're going to have to ignore the pain." Over and over and over and over for more than three days. And, the pain wasn't the problem, and I told every single one of them that. I can walk if it hurts. I can't walk if I'm physically not strong enough to stand on my own two feet.
Edited by Storm Bride - 8/7/11 at 8:28pm