Thursday, August 23, 2007

Afterbirth, a Cautionary Tale

I've told Devin's birth story before. I won't repeat it here. Suffice it to say, it was progressing much like Trevor's birth, so I felt sure I was going to be at the hospital long enough for him to be born on October 13th. Just *Knowing* that a long night lay ahead of me, I asked for an epidural before I really needed one. My advice to myself was "Sleep" since I just knew this was going to take awhile. That's what the birth of Trevor had taught me. So, around 10 or 11 PM, an awfully handsome Indian doctor came in to administer the epidural. I'd like to give you his name, but I don't know how to spell it. Let me just write it phonetically. GOO-CHEE-POO-DEE. He was handsome and tall. And, Indian, too.

Since this is a cautionary tale, let me tell you about an epidural. First, you have to sit still while the handsome doctor puts a needle into your spine. His goal is to get a tube inserted into the spine so that an anesthetic can be administered to the lower half of the body. I think it took the handsome doctor several tries. Pregnant, about-to-give-birth women are instructed to sit perfectly still with a rounded back so the doctor can get the tube inserted perfectly between two vertebrae. I know that sitting perfectly still through contractions with a rounded back is not easy. I'm sure the handsome doctor's job was also a little tough.

During the needle insertion portion of my epidural, I went into what is known as transitional labor. It hurt. It was, ugh. Yeah, ugh. Before the epidural, I don't think my contractions even hurt. I wouldn't have known I was having them if it weren't for the monitor. During the epidural, I thought something was going wrong because, all of a sudden, I hurt and breathing was difficult. It was just labor, though.

Lo and behold, the epidural provided no relief during the next 20 minutes, and then Devin was born.

To prove the epidural had no effect, as soon as I was alone, I went to the bathroom all by myself.

Now, listen. I'm not mad at the tall, handsome Indian doctor. I'm mad at me for thinking I knew what was going to happen and asking for that epidural in the first place.

Fast forward to the next day. Holding my new little baby in my arms, my head hurt so bad, I could barely keep my eyes open. I mentioned it to the doctor doing rounds. He said that Dr. GOO-CHEE-POO-DEE was so good, that it certainly couldn't be a spinal headache. I have never had a spinal headache before, so I made the silly assumption that if the doctor on rounds said it wasn't a spinal headache, it must not really be a spinal headache. I'm not mad at this doctor, either. I shouldn't have listened to him. My bad.

The other reason Dr. Rounds (who certainly wasn't handsome or I would have remembered it) thought it wasn't a spinal headaches was because I was too lucid and not in enough pain. The thing is, I think I have a high tolerance for pain. But, it wasn't pretty.This is the face of a woman with a Spinal Headache. Don't let it happen to you.

So, for the time remaining in the hospital, I suffered through this headache. On the advice of the doctors, I drank a lot of water and took a lot of caffeine. Then, we went home, and I continued to suffer through this headache all the while drinking lots of water and taking a lot of caffeine. I could control the pain this way unless we were in the car. A spinal headache occurs when there is a hole in the dura. As I understand it, the dura is the sheath that covers the spine. This hole allowed spinal fluid to leak out of my spinal column. This caused the fluid level around my brain to drop ever so slightly. Since my brain wasn't as cushioned as it normally was, any jostling hurt really, really badly.

And, we were taking Devin to the hospital every day for a blood draw since he was jaundiced. So, my poor brain got at least 40 minutes of jostling a day. And, Devin kept getting poked.

By Saturday, I was done with the pain. Why I had to wait until Saturday to have enough of the pain was beyond me. Why I waited at all, though, that's what I want to advise against.

Since I had waited until Saturday, I had to go to the ER. We all went, this brand new family of 4. My head hurt, and my access to water and caffeine was limited as I waited for 6 hours to be seen. Plus, we were waiting on the delivery of a bili-blanket for Devin. My timing for seeking treatment was really horrid. On a weekday, I could have made an appointment. If I had asked for treatment while I was at the hospital right after giving birth, that would have been even better!

Finally, exhausted from waiting, and feeling like suffering at home was better than suffering at the hospital, we decided to leave. I got my stuff, my kids and my husband, left the room where I had spent most of that Saturday, and I told the ER Doc I was going home. He was belligerent. Not with me. He was upset with the Anesthesiologist who had been paged hours ago. He got them on the phone, told them this was unacceptable, and finally I was seen.

It wasn't the handsome doctor. It was a nice little woman who had given me the epidural I got with Trevor. She's the best. I didn't get a spinal headache with her epidural, and she came in during my transitional labor with him and offered to push more meds. She rocked.

The treatment for a spinal headache is called a blood patch. Blood is taken from your arm and then inserted into the spine (repeat of sitting still with rounded back). The blood coagulates over the hole in the dura, spinal fluid stops leaking, brain gets its cushion back, quality of life improves.

And, my quality of life did improve. Devin was gassy and cried a lot and wanted to be held a lot and I took lots of pictures during my 3 months off and one of my co-workers died in a car wreck and haunted me when I returned to work and our house was warm and bright and Trevor strung together words in his first brilliant sentences (imagine a musical montage, please).

Yes, life improved, and I learned a lesson I already knew. I'm in charge of my health and well-being. And, even the really handsome and highly skilled doctors can nick your dura every now and then.


Mary said...

Trish, What a story. I had no idea you went through all that. If I did know, I forgot it.
Oh boy, I'm the first to comment.
Love, Mary

MOM said...

TIna, at work, read this story. She said, she had spinal menengitas, sp?, and she had a really bad headache because she had to much fluid around her brain. They had to drain some out to help her. I guess either way to little or to much fluid is not good.
Love you all