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Epidurals are a miracle technology

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Re: Epidurals are a miracle technology

#71

Post by amluto »

brookside wrote: post #4
DivingForGold wrote: post #2

Male scheduled for my 3rd epidural with steroids next week for on-going spinal stenosis, relieves pain for a few days, then back to pain. Will go for minimally invasive micro laminectomy next, tired of treating symptoms and not the root cause. In that procedure surgeon will remove parts of lower vertebrae that is pinching the nerve bundle, nerves that progress down each leg. Success rates of better than 70%, it's a g…

(While it's clear you've done a ton of your own research for your own case.) Steve Kerr's advice after his own back surgery complications (albeit microdiscectomy, not a laminectomy) make me hesitant: "If you're listening out there, if you have a back problem, stay away from surgery... Rehab, rehab, rehab. Don't let anybody get in there."

The heuristic I found when researching this a few years ago was slightly more nuanced than your quote: back surgery is very likely the wrong solution for back pain.

But if you have nerve problems caused by an issue with your spine, you probably want to address them before they become worse or irreversible, and back surgery may end up being the only option.

Re: Epidurals are a miracle technology

#72

Post by nikolay »

biggc wrote: post #68
nikolay wrote: post #66

... Except when they injure your spine, like with one of my friends. I'm not sure why women choose painless childbirth, which is not only potentially bad for them, but for their newborns as well. My wife gave birth to 3 children, two in the US, and doctors were shocked she didn't want them. Yes, it hurts. The moment your child is born, all pain is gone, and you're in the most beautiful state ever, and this creates ev…

Suffering is not a virtue

It surely is. Ascetism and stoicism are extinct virtues, maybe venerated only in Eastern Orthodox Christianity. Many of our holy fathers have suffered terrible torture and death, but they even welcomed it. That's why Orthodoxy is so hard to grasp in the West, where people damage their livers just to tame their headache a bit, let's say.

Re: Epidurals are a miracle technology

#73

Post by wl »

nikolay wrote: post #66

... Except when they injure your spine, like with one of my friends. I'm not sure why women choose painless childbirth, which is not only potentially bad for them, but for their newborns as well. My wife gave birth to 3 children, two in the US, and doctors were shocked she didn't want them. Yes, it hurts. The moment your child is born, all pain is gone, and you're in the most beautiful state ever, and this creates ev…

There's a lot of people out there who blame their epidurals for lower back pain and the like, but the evidence for causality is not there.

Re: Epidurals are a miracle technology

#74

Post by chrismorgan »

eblume wrote: post #29
mef51 wrote: post #24

I've heard a few times now that giving birth while lying on the back is a relatively modern invention and that for most of history women adopted squatting or leaning forward positions.[1] And that the back position is actually much more painful. How much does laying on the back increase the pain to the point where an epidural is necessary? Is it still necessary in the other positions? disclaimer: I know nothing about…

When you've been given an epidural, you are generally required to be in a bed. (This doesn't answer your question, but I think it is relevant.)

My wife works at a leading private maternity hospital in India. I can’t yet report from personal experience, but my wife says that epidurals are normal procedure, and per the hospital’s published statistics, about 90% choosing to give birth propped up or squatting (this figure excludes C-sections, water births, and complicated cases), which implies not being in a bed for at least the last part.

Re: Epidurals are a miracle technology

#75

Post by chrismorgan »

nikolay wrote: post #72
biggc wrote: post #68

Earlier quoted context omitted.

Suffering is not a virtue

It surely is. Ascetism and stoicism are extinct virtues, maybe venerated only in Eastern Orthodox Christianity. Many of our holy fathers have suffered terrible torture and death, but they even welcomed it. That's why Orthodoxy is so hard to grasp in the West, where people damage their livers just to tame their headache a bit, let's say.

It’s funny, because Paul criticised such thought in Colossians 2:23:

> These have indeed an appearance of wisdom in promoting rigour of devotion and self-abasement and severity to the body, but they are of no value in checking the indulgence of the flesh.

Meaning: sure, looks good, but doesn’t actually help if the suffering itself is your goal.

(Notwithstanding this, Acts 5:41. A lot, in such topics, depends on exactly how you present things.)

Re: Epidurals are a miracle technology

#76

Post by Broken_Hippo »

tptacek wrote: post #18
Broken_Hippo wrote: post #16

Earlier quoted context omitted.

I'm with you until I remember how expensive medical school plus internship is in the US. If doctors cannot pay back their student loans, it doesn't matter. The majority of folks in medical school have family that can support them now - not fixing education will make this even worse. Don't get me wrong. I support state-sponsored health care, especially after moving from the US to Norway over a decade ago. Just the pea…

Medical professionals in the US make multiples of what the same professionals make in Europe.

For what benefit? Graduating medical school with an average of $250k of debt?

Unpaid time off and possible job loss if you have medical issues that require you to be off work? They still worry about health insurance and things like that. Poor work/life balance, no promise of using vacation time, especially weeks at a time? The worry of lawsuits? Little to no job security?

Money isn't everything. Money can't really buy the quality of life that legal protections can - it is harder to lose legal protections.

Re: Epidurals are a miracle technology

#77

Post by exolymph »

chrismorgan wrote: post #74
eblume wrote: post #29

Earlier quoted context omitted.

When you've been given an epidural, you are generally required to be in a bed. (This doesn't answer your question, but I think it is relevant.)

My wife works at a leading private maternity hospital in India. I can’t yet report from personal experience, but my wife says that epidurals are normal procedure, and per the hospital’s published statistics, about 90% choosing to give birth propped up or squatting (this figure excludes C-sections, water births, and complicated cases), which implies not being in a bed for at least the last part.

No, you can squat in the hospital bed. (Source: have given birth.) I'm not sure whether this is the same in India, but in the USA most hospitals don't want you to get out of bed post-epidural because you're a fall risk which incurs legal liability.

Re: Epidurals are a miracle technology

#78

Post by causality0 »

thelastgallon wrote: post #35
causality0 wrote: post #28

Earlier quoted context omitted.

I have to cautiously agree with you, with the caveat that many physios don't seem to know what they're doing either and the effectiveness of therapy can differ wildly based on which therapist and what regimen they use. Speaking as someone with a herniated disc that went through a discectomy which re-herniated immediately following surgery. Frankly I've only just now started getting relief by reducing the amount of we…

> Speaking as someone with a herniated disc that went through a discectomy which re-herniated immediately following surgery. Sorry to hear about re-herniation. Thats what I am concerned about. I have multiple disc herniations, one with cauda equina. Multiple neurosurgeons have recommended surgery, but each is going to do a different procedure. I understood as they don't fully understand whats the root cause, everyone…

While I have no medical opinion to back this up, I place a significant portion of blame on the mechanics of being released. I was upright in a wheelchair, then forced to stand up to get into my wife's car, then had to drive home upright, then had to stand up again to get into a wheelchair to get into my house. I believe the fact that my back was forced to take weight immediately following surgery did a lot of damage. If I could do it over again I would have insisted on remaining prone for at least the first 24 hours.

Re: Epidurals are a miracle technology

#79

Post by chhxdjsj »

wl wrote: post #40
rocqua wrote: post #36

There's a very strong podcast series about the common failure of Epidurals: "The retrievals" season 2, by serial productions. I found it rather eye-opening. The series includes reporting on a conference of the Society for Obstetric Anesthesia and Perinatology (SOAP) where the professionals in this field also found it eye opening. (mostly episode 2) I don't bring this up to say that actually Epidurals suck, just to br…

The problem that The Retrievals deals with is epidurals failing during cesarians, which, they're quick to emphasize, is painful, open abdominal surgery. The not-so-simple solution is to convert to general anesthesia (anesthetic gas, IV propofol, etc). This isn't without its risks to the mother and the child, so there's reluctance on the part of anesthesiologists to go that route if there's other options. The result i…

anesthesiologist here, I really fear a dodgy epidural being used for caesarean section surgical anaesthesia, and if there is any hint that an epidural isnt perfect I pull it out and do a spinal anaesthetic (as long as I have time eg. If the baby can wait long enough). Its a big call which needs to be made quickly. I have a theory that modern epidural medication mix has been dropped to be so low concentration of active drug that it is harder to differentiate a good epidural from a patchy one, and as a result people are topping up patchy epidurals and then running into problems with pain during surgery.
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