With the itching, the thing that helped was to let my nurses know. They gave me something (probably diphenhydramine, which is the active ingredient in Bendryl) that made all the difference.
Don't be afraid to push the nurse button and communicate what you are experiencing and ask for help.
Yes, yes! I agree about the meds and the IV fluids! The morphine they gave me with my second made me itch so horribly, but I didn't get morphine my first time, and I had no itching. I did have a severe reaction on my abdomen to the adhesive on the sterile field drape my first section, so I made sure they double washed me with iodine with my second. It helped, but I still needed prescription cortisone.
Also, I LOVED using an abdominal binder after both surgeries. I felt it really helped support my tired muscles, and keep my incision protected. Really helpful.
For me, personally, I liked having the catheter out within ten hours. It was hard hard hard to walk to go to the bathroom, but I think it made a difference in my recovery and I was only in the hospital two days.
Adhesive from the drape?? Wow, I had no idea that might be to blame for my itching!
I had full body hives last time and could see the outline of the staples and adhesive for over 3 months on my belly from something. They claim they'll use something "hypo-allergenic" this time, but since aloe gives me eczema and non-latex band-aids give me rashes (and my hospital is latex free), that word means little to me.
But now that I'm thinking about it, I ought to make sure to up my Vit. C and D doses for the next couple days to try and carry me through and hopefully help my system dead before my surgery.
I'm trying not to focus on the potential negatives though and think about how exciting it will be to finally hold my baby girl at this point. :)
I was dosed with quite a bit of benedryl and it didn't help the itching at all. It was explained to me that the itching isn't actually an allergic reaction so the antihistimines in benedryl don't work (so basically they they were giving it to me for the placebo effect?). I've done some further reading and it seems there are other meds they can give that help with the itching but the protocol differs dramatically from place to place.
I was doing some research on this and it seems like there are lower rates of complaints of itching for people given morphine in an IV as those given morphine in the epidural.
Here's a research article about the effect of morphine comparing different administration techniques:
http://www.anesthesia-analgesia.org/content/95/2/436.full#T1
With the itching, the thing that helped was to let my nurses know. They gave me something (probably diphenhydramine, which is the active ingredient in Bendryl) that made all the difference.
Don't be afraid to push the nurse button and communicate what you are experiencing and ask for help.
I was also just reading a board of anesthesiologists and a) they were totally dismissing the itching problem and b) several said that they use duramorph for every single c-section they've done. This is really scary to me!
Actually, Benadryl should help because it is a histamine reaction and Benadryl is an antihistamine. Duramorph is standard because it results in better pain relief with a lower dose of narcotics than IV PCA. Some hospitals do PCEA (epidural PCA), which is supposed to be great, but that requires an epidural to be inserted and not all anesthesiologists want to do an epi or CSE for a section just so you can have the PCEA. If you have any questions about the anesthesia or the initial post-op analgesia, ask for an anesthesiology consult.
Drape drops and photos may not be up to the OB. Some hospitals have blanket policies against this for legal reasons--mine permits photos inside the OR but NOT of the surgery (once baby is out and on the other side with the nurse/ped, you can take pics). If the policy is set by Legal, your OB can't override it, so find out.
What made my second section positive was just discussing everything with the OB beforehand. There were a few small things I'd change (how we handled the baby between birth and recovery--I would have delayed the bath, in retrospect, and I think the initial exam took a little too long--I would have liked a little longer with the baby in the OR, even though I don't want to try nursing on the table. It's cold!)
I did my pre-op and recovery in a regular LDR, and baby was with me the whole time in recovery--they brought him back from his exam before they finished closing me up. That was really nice. I felt more like I was having a birth and less like I'd just been booked in for surgery.
Oh--if you have any tendencies towards anemia, manage it aggressively! if I have a 3rd i am pushing for iron infusions rather than doubling up on tablets. I was 9.8 on delivery day and after the blood loss from surgery, things sucked. My BP was down to 89/48 and I nearly got transfused. (Normal BP: 165/110 unmedicated, 120/80 on beta blockers.)
Breastfeeding on the table was the best part. I was told it wouldn't happen by my OB (she said there was insufficient space between my breasts and the drape. But, the L&D nurse just held dd2 upside down (her head pointed at my feet) over my shoulder, and she nursed that way. It helped a lot.
Great infomation. Thanks for sharing this.
For me, getting a shower as soon as possible after my c-sections really helped me feel like a human being again. I brought my own jammies this time and it felt nice not to be stuck in the hospital robes. I also used an abdominal binder on and off this time around and it helped with getting in and out of bed. Ask PT or nurses to show you the best way to get out of bed. Rolling to the side and then getting up slowly worked best for me.
I've always stayed in the hospital gowns for the first day or so, then switched to my own bathrobe or nightgown. I don't really like pajamas, and switching to my own nightgown doesn't work out that well while they're still fiddling with things.
I also opted out of the morphine, after it made me itch like crazy with my second one (honestly don't remember about my first - I was in awful shape from all the drugs, lack of food, etc. and it's mostly just a miserable blur in most ways). Unfortunately, the anesthesiologist with my third one didn't ask - he just went ahead and added it to my IV. So, I got the insane itching that time, too. With my last, I got the PCA. That worked way, way better for me. I took a hit before i got up to use the bathroom the first time, and just before I tried to sleep at night, and that was it. I have found my views on pain vs. pain medication to be somewhat atypical, though - I'd rather be clearheaded and in pain than muddled and/or numb.
I definitely agree about having someone there with you, if possible. I've been really lucky, because my mom lives close to the hospital, so my family stayed with her, which left dh able to come and go from the hospital as he pleased. He stayed with me at night, except with ds2 (dd1 was only two, and he didn't like leaving her all night), and was with me most of the day, as well. It made a big difference to have someone on hand who knows you - not just to help out with the logistics, but sometimes you want to talk, yk?
Oh - and not so specific to recovery, but I always bring a good book (Terry Pratchett, by preference) and my iPod (well, it used to be my CD player). If the baby happens to be sleeping, and there's nobody around, I find music the easiest way to get ouf ot the hospital in my head...and a book always makes meal times less boring. :)
Someone else mentioned that she had no breastfeeding issues. I had an awful time with ds1, but when I look back, I realize it had more to do with the constant interference (I know they were trying to help, but they didn't) from nurses, and people just always being in my face. I do best when I can just take it easy and work things out for myself, so having a constant stream of contradictory advice and people checking my nipples and the baby's latch and all the rest of it just drove my stress level through the roof. I don't think my problems had much to do with the c/s. With my second, it was also rough, and I do think that was c/s related - dd1 wasn't ready to be born, and my body wasn't ready for the baby to be out, and I had a lot of issues with pain and lack of milk. And, with my last two? Easy as it gets. DS2 nursed like a champ from the first feeding (in recovery) and so did dd2. The most common explanation I hear for c-section related breastfeeding difficulties is the mom's pain making it difficult, but that wasn't my experience at all! It hurt a lot, but everything hurt, and it really wasn't a factor.
Music via earphones ... totally a great way to get 'out' of the hospital, stormbride.
Music via earphones ... totally a great way to get 'out' of the hospital, stormbride.
This. This. This.
My local hospital isn't terrible - not great, but not terrible. But, the one I went to when I had Aaron had horrible, horrible food. Everything was white flour and highly processed, and I think I got about a serving and a half of fruite and vegetables (combined) a day...maybe three, if I count the sickly sweet orange juice. I think the trays were over 50% carbs, mostly sugar and white flour, and had no flavour. Fortunately, my loved ones fed me better than that!
Oh, man, having someone bring in food is SO IMPORTANT. My best friend brought smoothies and I could not get enough of those. She also brought yummy sandwiches from the gourmet health food store. Pure bliss. Unlike some surgeries, there are no dietary restrictions once the surgery is over, so have some good food.
I think someone mentioned constipation. Man, this one nearly killed me. I felt like I got my pushing stage and birth a few days out of the hospital when I passed my first BM. UGH! Next time I will make sure to do everything possible to keep things moving smoothly.
Oh, man, having someone bring in food is SO IMPORTANT. My best friend brought smoothies and I could not get enough of those. She also brought yummy sandwiches from the gourmet health food store. Pure bliss. Unlike some surgeries, there are no dietary restrictions once the surgery is over, so have some good food.
This depends where you are and/or on your doctor. I was on fluids only for the first little while (actually, 3.5 days, the first time!) until my last one. The rule was that I couldn't eat until I'd passed gas. But, after dd1, I just ignored it, and got dh to bring me fruit. I never thought of smoothies - wish I had. That would have really, really hit the spot.
I think someone mentioned constipation. Man, this one nearly killed me. I felt like I got my pushing stage and birth a few days out of the hospital when I passed my first BM. UGH! Next time I will make sure to do everything possible to keep things moving smoothly.
Yeah. It's bad. I found eating a bunch of plums, peaches, bananas, etc. made a big difference. I think it was partly because of their fluid content, although I always drink lots of water, too.
You know, now that you mention it, I had my c-section at night, and my friend brought food the next afternoon, so you may be right about having to wait on solids. I can't remember now, to be honest. I might have been that it was almost 24 hours anyway.
Oh, man, having someone bring in food is SO IMPORTANT. My best friend brought smoothies and I could not get enough of those. She also brought yummy sandwiches from the gourmet health food store. Pure bliss. Unlike some surgeries, there are no dietary restrictions once the surgery is over, so have some good food.
I think someone mentioned constipation. Man, this one nearly killed me. I felt like I got my pushing stage and birth a few days out of the hospital when I passed my first BM. UGH! Next time I will make sure to do everything possible to keep things moving smoothly.
Food: I have NEVER been so hungry or thirsty after my second child was born (via c-section). One night when I was up for the zillionth time, I got a cut watermelon out of the fridge, put it on the counter, and lowered my face into it for a bite since my hands were quite full. Food, for me, was the best gift--especially if it could be eaten one-handed! My DH would pack night snacks for me, which was WONDERFUL. A peanut butter sandwich and a juice box (so you don't have to get out the juice, the cup, pour, and transport to wherever you're sitting) were very appreciated. I was lucky he was so considerate, I know. I did 100% of the nighttime parenting, so I figured I was due for some being taken care of!
Regarding the constipation: my, yes. The narcotics did me in, I guess. I did tons of water, mad fiber, cherry juice, walking, and stool softeners, none of which worked. An enema did. I now give them along with regular gifts if a friend is having a c-section.
I put the bit in about the catheter because I know at least one person on MDC who has said that it was inserted before her epi was effective and she found that particularly traumatic.
I've had to self-catheterise or had prolonged indwelling catheters at various points in my life (post spinal surgeries, mostly) so I, personally, don't find catheters a big deal anyway. After my c-section mine was in for 24 hrs with lots of messing about with measuring urine volumes and post-voiding scans of my bladder because of my existing issues, but obviously my experience is not the rule!
I only got 2 litres of IV fluids total, and they were run in over about 4 hrs, although the IV cannula stayed in the full 3 days of my stay (I got an extra 24hrs more than the usual 48hr stay because of my medical issues). I am particularly obsessive about how much fluid I take in, because I need to work out if my urine output is ok, so I kept a note of the IV fluids! Unless you lost a lot of blood or can't drink, you don't need IV fluids post-op and can ask for them to come down.
If you can, ask for any Clexane/Lovenox/Heparin injections into your abdomen or buttocks- they're painful and you'll bruise, so I prefer not to have my arms affected. If you're very slim (under 50kg) check you get a lower dose. I always have to remind people that I need half the normal dose because of my weight (and check you get more if you're bigger too).
I like Fentanyl/bupivacaine for spinals- it doesn't make me itchy, drowsy or nauseated. Personally I don't like morphine because it makes me too tired and a bit loopy. I'm personally not fond of IV or epidural PCA, because I've found I can manage without them, and those rely on IV or epidural opiates, which I try to avoid, and mean more tubes and lines, which are constricting.
Spinals are weird- the sensation of being paralysed is not pleasant and not something I ever get used to. The issues with my spine have put me at risk of paralysis in the past, and it is pretty frightening to be unable to move and have that running through the back of your mind too. The jerks and twitches as the sensation comes back to your legs can also be scary if you're not expecting them!
For post-op analgesia I like oral Diclofenac and paracetamol (acetominophen), with oral codeine (15-30mg) as my emergency back-up painkiller (but if I take that laxatives are definitely needed). This regime has been fine tuned over time and is personal to me, obviously you might need to try a few things before you get what works best for you. I found I needed pain killers during my hospital stay after the-section, but once I was home managed without them, although I was very gentle with myself for a while!
Because I have some mobility issues the midwives were very helpful making sure my daughter was within arm's reach, and that the bed was always at the correct height so I could get into and out of it easily, and reach her. The bed height is adjustable- but often set at a convenient height for the medical staff- remember it might not be at a convenient height for you!
Adhesive from the drape?? Wow, I had no idea that might be to blame for my itching!
I had full body hives last time and could see the outline of the staples and adhesive for over 3 months on my belly from something. They claim they'll use something "hypo-allergenic" this time, but since aloe gives me eczema and non-latex band-aids give me rashes (and my hospital is latex free), that word means little to me.
But now that I'm thinking about it, I ought to make sure to up my Vit. C and D doses for the next couple days to try and carry me through and hopefully help my system dead before my surgery.
I'm trying not to focus on the potential negatives though and think about how exciting it will be to finally hold my baby girl at this point. :)
Yes, it was really really bad after my first cesarean. It was the exact outline of the surgical drape. At first we thought it was the abdominal binder, but I didn't have any problem on my back, so we talked to a few doctors and figured it had to have been from the sterile field. The adhesive had literally given me a ten out of ten dermal reaction. My skin looked like bubble wrap. (sorry sorry, not to scare!) but I guess this is kind of a rare, yet real issue with the surgical sterile field drape thing. Having them wash me several times afterwards and using a cortisone cream really made it fine after my second surgery. I had some irritation, but man, NOTHING like the first time. But I did have the IV morphine the second time, and I'm not sure what I had the first time, but I know the Morphine gave me full body itches until they put some other thing in the IV to stop it. Oy. I'd love to avoid that!
BUT, knowing these things now, I know that if I do have to have a third cesarean, I will be prepared in order to deal with those discomforts that CAN be avoided and have a better physical experience. :)
Ohh, and my number one best piece of advice is to give yourself an enema (saline) the night before your scheduled c-section. For me, it made a huge difference in comfort. Then, when I was home a few days later, I gave myself another one. After that, I was pretty much healed enough that I had no issues in that department that a little colace couldn't see me through...perhaps TMI, but this is important stuff!
Spinals are weird- the sensation of being paralysed is not pleasant and not something I ever get used to.
That's another thing ... if you've never had an epidural before, be prepared to not like it one little bit! I felt claustrophobic and helpless, two feelings that I did not appreciate at all. I detest the sensation. I think it was the worst part of the entire rushed, panicked, unplanned experience for me.
The other sensation thing that surprised me is how your tummy (around the external incision and where they did the internal suturing too) stays numb for sooooooo long! I've heard it can be tingly or numb for up to a YEAR after! I swear, I could use my tummy as a pin cushion and I wouldn't feel a thing!
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