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A VERY hypothetical question about c-sections and anesthesia... - Page 2

post #21 of 50
I had one spinal and one general, and to be completely honest, I preferred the general.

With the spinal, it took FOREVER (7 hours) for me to get the feeling back in my lower half of my body, and I felt dopey and out of it for at least 4 of those hours...which means I dont really remember holding DS the first time. I took one hit of morphine off the pump, and then half a perc every 8 hours for the next day, and then nothing afer that.

With the general, aside from my throat being sore from being intubated, I felt totally fine within about 30 min of getting to my room from recovery. I remember holding my daughter, and I didn't feel loopy. I needed more pain relief the second time around because the incision hurt more (go figure, chasing a toddler around in addition to caring for a newborn will do that to you), but I was off the prescription strength stuff after a couple weeks.

I actually just had emergency sinus surgery for a mass in my sinus, and was under general again, and was feeling fine within about 20 minutes of being in the recovery room. : They gave me a prescription for Lortab, but I didn't even need Tylenol....

I think my body metabolizes stuff weirdly. Big pain I can handle. Small pain makes me want to cry. I did 6 hours of Pitocin labor with no pain meds, then had a shot of Nubain to take the edge off, then got to complete within the hour....but I was in tears when the nurse put my IV in for my sinus surgery 2 weeks ago. :

Sorry if that strayed off topic a bit.
post #22 of 50
i had a really crappy birth. it was a c/s. in the middle of it (it took over an hour just to get into my abdomen and get my baby out, never mind the prep or the sewing up after), the ansethesiologist asked me if i wanted to be knocked out because i was wailing, thinking my DD might be dead, since it was taking so long and we knew she was stressed.

he asked repeatedly if i wanted to go to sleep, and i finally yelled, "no! i want to be awake when she comes out. i want to see if she's dead or alive. i want to see her either way! don't you dare put me under!"

so i'd definitely fall squarely in the "you will WANT to be awake no matter how bad it is" camp. i thought my DD was going to come out dead (really truly thought so), and i still 100% wanted to be awake for it. and believe me, they were giving me PLENTY of calm down meds, and i still felt PLENTY upset. i don't feel robbed of my emotions whatsoever.
post #23 of 50
Thread Starter 
Quote:
Originally Posted by readytobedone View Post
i had a really crappy birth. it was a c/s. in the middle of it (it took over an hour just to get into my abdomen and get my baby out, never mind the prep or the sewing up after), the ansethesiologist asked me if i wanted to be knocked out because i was wailing, thinking my DD might be dead, since it was taking so long and we knew she was stressed.

he asked repeatedly if i wanted to go to sleep, and i finally yelled, "no! i want to be awake when she comes out. i want to see if she's dead or alive. i want to see her either way! don't you dare put me under!"

so i'd definitely fall squarely in the "you will WANT to be awake no matter how bad it is" camp. i thought my DD was going to come out dead (really truly thought so), and i still 100% wanted to be awake for it. and believe me, they were giving me PLENTY of calm down meds, and i still felt PLENTY upset. i don't feel robbed of my emotions whatsoever.
See... things like this make me believe it really should be a CHOICE. And, that everyone really does respond to medication differently!!
post #24 of 50
wanted to add, i would have to agree that i had no memory loss whatsoever. i remember everything about the birth. sometimes wish i didn't, but in the moment i wanted to be in the moment, so there you go.
post #25 of 50
Thread Starter 
Completely off topic but, Heather I just noticed your sigline, and the ribbon ...

My bf's mom just had a double mastectomy... and my good friend also had a mastectomy... my friend isn't doing nearly as well ... she already had it years ago but it came back and now isn't responding to chemo. It's an issue that is very close to my heart right now.
post #26 of 50
I had said after our first experience that, if I needed a repeat c/s, I'd want a general. My body doesn't react predictably to Lidocaine, and I FELT PAIN during my son's birth. I've had several other surgeries under GA, and aside from one of them, recovered quickly from the drugs with no adverse side effects.

There was a thread on here a few months back about the topic, and one poster had her DP "guest post" as an anesthetist, I think. He explained *exactly* what the issues are with GA for pregnant women and during birth. After that, I decided that it would be really irresponsible for me to *choose* GA if it wasn't absolutely necessary. The risks are just too great for mom and baby (and are different from the risks for a non-pregnant person).

It would *also* be incredibly irresponsible for a practitioner to accommodate my request for GA without attempting to educate me on the issue... just as it IS really irresponsible for practitioners to accommodate requests for elective c-sections or convenience inductions without attempting to educate women on just what the risks and issues are.

We're not the same person, and what is just way too risky for me might be appropriate for you... but physicians are *supposed* to advise their patients on what the risks of a particular option are, and yes, they will likely attempt to convince patients to accept the much-less-riskier option. They will also sometimes draw the line at not prescribing medications that will put a patient at risk without any tangible benefit. If, in your case, you see GA as having a benefit that outweighs the much greater risks, then it would be up to *you* to convince your provider of that.

Glad it's all just a hypothetical question for you... if it's got you THIS worked up, when it's not even in the offing, eek. I may actually have to MAKE this decision in the next couple of weeks, if things don't go well for our birth.
post #27 of 50
Thread Starter 
Many, many many times though women in labor / birth situations are pressured to accept medication because the practitioner thinks it's best... ie drugs to calm her... I was forced into accepting at least three different medications that I did NOT want, that I reacted badly to, and was given MORE of them when I told them I didn't like how I was reacting, during my ds's birth... and also after a surgery I had a couple of years ago ~ again, didn't want a certain medication, and again was administered it anyway despite my speaking out against it.

For this to go on, and then for a dr to open up a woman's abdomen and be cutting around her insides ~ ?!! I stand by my previous analogy, although I have since edited it out since it is so obviously offensive. I think though that it is just as offensive ~ in my opinion ~ to suggest a woman just get meds to calm her down when she doesn't want to go through the experience to begin with. A woman who already has a traumatic past... who already knows where she "doesn't want to go" psychologically... to be coerced into just accepting medication so it can be done the doctor's way seems nothing short of a violation of her body, heart, and mind.

Ironica ~ yes it has me "worked up" ... and yes I am very glad it's not a decision I'll actually have to make ever. But I think that it's something women need to be talking more about, because I had never considered that a woman's wishes regarding her state of sedation (or non-sedation) during a massive surgery would be ignored... until today.
post #28 of 50
You know, I think I'd rather be awake, so long as they gave me whatever "relaxation drugs" everyone's talking about (not a big fan of drugs in labour at all, but obviously with a c/s that's out the window). Without them I'd probably be a nervous wreck. I've had surgeries before though, and I know from experience any nervousness I once had goes away once the drugs are in my system!
I know if I were knocked out I'd regret not seeing my baby's first moments. It's very important to me to get comfortable with the idea of c/s (not that I'm more likely than normal to have one) because if I don't face that fear now and it does happen for whatever reason I want to be able to come to terms with it as soon as possible, for my baby's sake.
post #29 of 50
I was given a choice, and when I said I wnated the spinal, the dr.'s were very happy. I was shocked the GA was even an option, short of an emrgency.

I've had to friend's that needed GA. One, they had touble getting the psinal in, and she finally said "enopugh! Just knock me out!". The other was an emergency, so no time for a spinal.


I was so scared during my c-section. I tohught they would check to see if the spinal worked, and they didn't check, and I was just so scared it would hurt. Then I heard the dr. tell the nurse they'd already made the 1st incision, and that the nurse could go get my mom. So I didn't worry about pain after that.

GA scares me, though.
post #30 of 50
I would have LOVED to have been awake for DS's birth. I'd had an epidural in place, so they tried to give me the spinal drugs. Thinking it had worked, they then made the first cut and it HURT! Not just pressure, but burning, searing pain. My right side was completely numb, but the left was pretty much unaffected and it was all I could do not to scream. They had to stop, kick DH out of the OR, and knock me out because they couldn't get the spinal to work. My first sight of my son was an hour later, when I woke up enough to understand what was going on around me. All I have of my DS's first moments is the two pictures a wonderful nurse snapped for us and a small piece of paper with his stats written on it (she wrote them on one of the wrappings for something from the surgery!)

Assuming I end up requiring another CS in future births, you can guarantee I will NOT go for GA unless there's no other choice.
post #31 of 50
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post #32 of 50
My sister had GA with her placenta previa.

She said she was still coughing a week later to get that junk out of her lungs.

Coughing and a repeat c-sec scar are not a good combination.
post #33 of 50
Quote:
Originally Posted by Storm Bride View Post
It seems very strange to me that doctors won't give a woman GA "just because she wants it", but people can choose to have totally elective cosmetic surgeries done - just because they want them - under GA. There's something there that doesn't quite add up, yk? Or...maybe there just isn't as much money in providing GA for terror as there is in providing facelifts for vanity?
Cosmetic surgery takes hours unlike a CS which, if it's an emergency, will take less than an hour. When breast implants are done the patient is on her back then, after the implants are placed, the patient is sat up so the doc can get a look at them in the "natural" position. Multiple procedures are often done so the patient is also moved around a lot. It's a lot of moving around, I doubt someone wants to lay there for five hours while in surgery and a spinal won't last that long. In the case of a facelift I can't see how you can do it while a patient is awake "Ok, I'm gonna peel back your forehead and scalp for a minute here..." The whole deal with the curtain is to keep the woman from seeing what's going on, if that helps or not is debatable. I know I don't want to see it on myself even though I've participated in many. GA also takes a while to recover and most moms want to see the baby right away and bond.

As far as the baby is concerned the medications given in GA go directly in the blood stream and quickly to the babe. Meds like propofol act quick and take a while to wear off (I've weaned multiple patients off propofol and it's slow). Anesthesia isn't just one med but a combinations of meds to gain the desired effect all which will get sent to the baby directly. The patient also has to be intubated which carries it's own risk. The meds given in a traditional CS do reach the babe but have to cross the blood/brain barrier so it takes longer and the babe receives less.

If I had to have a CS I'd be nervous about a spinal but I'd suck it up knowing that it's better to have a spinal than GA.
post #34 of 50
Spinal anaesthesia is MUCh easier to recover from than GA is. It's actually what they use for other surgeries these days too. My dad had his hip replaced last October and had spinal anaesthesia for that too. I think they gave him something to relax too, so that he didn't care so much. (Orthopaedic surgery especially is filled with all sorts of unpleasant sounds and smells).

Plus, no matter how awful you would feel about the whole experience, I imagine you'd definitely want to see and hold (and breastfeed) your baby as soon as possible once it was over. They only use GA if they need something very quickly and don't have time for a less impactful method.
post #35 of 50
Here's my experience...

I was not at all happy about the idea of an epidural, which is why I'd labored without any pain meds for about 20 hours in the hospital (another 20 at home before that). Unfortunately, I had pre-eclampsia, so I had to be there. When the time finally came for the c-section, the anesthesiologist said that my BP was too erratic for an epi/spinal, so she'd have to do general anesthetic. We were warned ahead of time that if that happened, DH would not be able to be there for the "birth."

When I got into the OR, I was still having STRONG contractions and was in agony. So when they put that mask over my face, I just breathed in as deep as I could... and that's all I remember.

Coming awake was torture. I was dreaming that I was wondering around this old, falling down house looking for a way to breathe. I knew that if I didn't find air soon, I was going to die. I could feel myself dying, because I couldn't breathe. (I was intubated and couldn't "feel" myself breathing, so I thought I wasn't breathing) I wanted to find air so that I could see my baby before I died.

In hindsight, it's tough to have been under GA for my son's birth, but it also may have been for the best. From what they told me later, the c/s was fairly harrowing, and my BP dropped extremely low and I lost a lot of blood. I'm not sure that I'd want to be awake for that.

But, if I had to have another cesarean, I'd want to be awake. I felt so disconnected to my son for months afterwards (now that he's 2 I sometimes still want to blame it on the c/s, but no, he's just 2!), and would hope that if I were awake for the surgery then I wouldn't have that feeling of "this isn't my child."
post #36 of 50
I had general anesthesia with my 28 weeker. I developed HELLP syndrome on the night of his birth and had to be delivered ASAP. Decision to incision in about 10 minutes.

They were toying with the idea of me having epidural anesthesia, but two things made them lean toward the general. 1. My condition was worsening rapidly. 2. I had been on heparin while on hospital bedrest to treat a clotting disorder and they were worried about bleeding issues.

I was sad that neither my husband or I were "at" my son's birth, but in a way relieved. He was a small IUGR 28 weeker at only 1.5 lbs. We weren't entirely sure he would survive. I think that would have killed me to be awake and maybe he didn't make it. The general anesthesia contributed to a lower 1 minute apgar for him also. So docs generally don't like to do GA unless it is really required.

On a positive note, my son is now 2.5 y/o weighs in at 32 lbs and is 39 inches tall. You would never know he started out life so small.
post #37 of 50
Quote:
Originally Posted by not now View Post
Cosmetic surgery takes hours unlike a CS which, if it's an emergency, will take less than an hour. When breast implants are done the patient is on her back then, after the implants are placed, the patient is sat up so the doc can get a look at them in the "natural" position. Multiple procedures are often done so the patient is also moved around a lot. It's a lot of moving around, I doubt someone wants to lay there for five hours while in surgery and a spinal won't last that long. In the case of a facelift I can't see how you can do it while a patient is awake "Ok, I'm gonna peel back your forehead and scalp for a minute here..." The whole deal with the curtain is to keep the woman from seeing what's going on, if that helps or not is debatable. I know I don't want to see it on myself even though I've participated in many. GA also takes a while to recover and most moms want to see the baby right away and bond.

As far as the baby is concerned the medications given in GA go directly in the blood stream and quickly to the babe. Meds like propofol act quick and take a while to wear off (I've weaned multiple patients off propofol and it's slow). Anesthesia isn't just one med but a combinations of meds to gain the desired effect all which will get sent to the baby directly. The patient also has to be intubated which carries it's own risk. The meds given in a traditional CS do reach the babe but have to cross the blood/brain barrier so it takes longer and the babe receives less.

If I had to have a CS I'd be nervous about a spinal but I'd suck it up knowing that it's better to have a spinal than GA.
I understand the difference. My point was that the woman can have GA for an entirely elective procedure, but when a procedure is being forced on a woman, she can't elect to have GA. There seems to be a bit of a double standard there (although I do realize there's the factor of GA being more dangerous for a pregnant woman).

I'm not "nervous" about spinals. They freaking terrify me. I find spinals about equal to the surgery itself in terms of how scary they are. Quite honestly, I've wished a few times that they'd just skip the anesthetic completely - at least that way, they couldn't pretend, to themselves or me, that they aren't hurting me when they cut into my abdomen.

All that said, I wanted general last time, but tried to get a spinal, so that I could see my baby and dh could be there. Stupid me. If I hadn't tried to have a spinal, my son might still be alive. I'll just go with whatever junk they want to stick me with next time, although I'm refusing that morphine crap that makes me want to tear my skin off.
post #38 of 50
Quote:
Originally Posted by kltroy View Post
Spinal anaesthesia is MUCh easier to recover from than GA is.
Yeah - but once I woke up from the GA last time, I felt mostly okay (different from my first, but they've changed the "cocktail" a lot since '93), whereas the time I spent in post-op after a spinal, watching a bp monitor, waiting to feel my legs, and desperately wanting to hold my baby, felt like an eternity.
post #39 of 50
Quote:
Originally Posted by danotoyou2 View Post
But, if I had to have another cesarean, I'd want to be awake. I felt so disconnected to my son for months afterwards (now that he's 2 I sometimes still want to blame it on the c/s, but no, he's just 2!), and would hope that if I were awake for the surgery then I wouldn't have that feeling of "this isn't my child."
FWIW, I've only had that feeling with one of my children, and she was delivered by scheduled section, with a spinal. I got over it, but it was hard. I don't know if the disconnect was more because the labour/birth hormones just weren't there, yet (she was taken at 39w, 2d - if her two full brothers are any indication, she wanted at least another two weeks), or more from the sheer terror of having a spinal and being awake, or from being separated from her for "so long" (only an hour and a bit, vs. 14 hours with ds1, but I was unconscious for that whole 14 hours, and wide awake the whole time with dd) or what...but it didn't happen with any of the others.
post #40 of 50
Quote:
Originally Posted by Storm Bride View Post
Yeah - but once I woke up from the GA last time, I felt mostly okay (different from my first, but they've changed the "cocktail" a lot since '93), whereas the time I spent in post-op after a spinal, watching a bp monitor, waiting to feel my legs, and desperately wanting to hold my baby, felt like an eternity.
: The 7 hours until my legs had feeling again were the longest in my life (I don't know why it didn't occur to me to either lie to the staff or demand I could hold him sooner - I was such a doof back then). With the GA, once I was awake and in my room (about an hour), I was awake and fine (A little sore throat, but that's it). I was much more alert and oriented once I was awake from the GA than I was with the spinal; it took me several hours to stop feeling dopey when I had the spinal.

I think everyone recovers and handles things differently. : Cause I hate, hate, HATED the spinal. And the GA was, well, fine.

I didn't have any disconnect feelings with either baby, so I can't give any anecdotes about that, but I feel badly for any mamas who have.
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