quote:Originally posted by beverly: But the logic here is that it is *highly* unlikely that any laboring woman coming into the hospital will have been fasting long enough for general anesthesia to be safe *anyway*.
So considering the rarity of the need for general anesthesia in birth, why require this in-hospital when most women have already ruined the chances of it being safe?
Why not instead have the policy be that the woman (or whoever came with her) should report what she has been eating/drinking for the last few hours? If she qualifies for safe GA, then maybe counseling her to keep doing so would actually be worthwhile. Otherwise, it just seems like needless beaurocracy.
Hmm. I think it has to do with perspective. From a laboring woman's perspective, it is unlikely this will come up for her. From the caregivers' perspectives, we know that a certain number of women we care for will be affected -- we just can't predict which ones.
The tricks anesthesiologists can do to deal with stuff in the belly can be pretty traumatic. Useful if necessary, but much better to avoid. An extra-wide breathing tube or one with an over-inflated cuff can help block the reflux -- but it increases the damage to the surrounding tissue and really ups the risk of scarring. Pumping the stomach can trigger contractions at a time when you definitely don't want them (like a placental abruption bleeding out) -- and remember, if they are pumping before giving the anesthesia to make the anesthesia safer, then the uterus muscles can still contract.
Where I trained, there were something like 20-40 births a day. Probably less than 2% had any significant problems at all, but we saw a few hundred patients a week, and so you knew that it would turn up. You only need to see one person who sucked acid into their lungs to never want to see it again.
But for each 5 women we saw with problems, there were hundreds that sailed through delivery, relatively speaking. Is it worth restricting all of them in order to try to save the few from serious complications? I don't know. I do think people should be able to decide things for themselves, but if you haven't seen what can happen, it's hard to make an informed decision.
On the other hand, if all you see are the worst things that can happen (like those of us who only get called in when things go bad), then your view is probably skewed the other way.
Anyway, it is your body, and I would suppot you in whatever you chose. I'm pro-beverly. I did want to offer another perspective to take into account, that's all.
Posts: 14017 | Registered: May 2000
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quote: Is it worth restricting all of them in order to try to save the few from serious complications? I don't know.
This is the sort of difference in perspective I speak of when I compare a birthing center to a hospital. I prefer the relaxed atmosphere. And considering it seems I'm in danger of aspirating acid *regardless* of having broken hospital policy, I think I'd rather take my chances with a tummy tube.
quote:Anyway, it is your body, and I would suppot you in whatever you chose. I'm pro-beverly. [Smile] I did want to offer another perspective to take into account, that's all.
Thanks, CT, I do appreciate the sentiment. But unfortunately I still have to suffer through my hospitals policies--no matter how silly *I* think they are. They put their policies before me, it seems. I really like having the choice--it puts the power back in my hands.
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But bev, it seems to me that 10 cups (and they were 10-oz. cups) full of ice in the span of 2 1/4 hours is a lot of water. Posts: 21182 | Registered: Sep 2004
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quote:This is the sort of difference in perspective I speak of when I compare a birthing center to a hospital. I prefer the relaxed atmosphere. And considering it seems I'm in danger of aspirating acid *regardless* of having broken hospital policy, I think I'd rather take my chances with a tummy tube.
The risk levels are different, but I appreciate your desire to stay in charge. That, too, is important.
quote:Thanks, CT, I do appreciate the sentiment. But unfortunately I still have to suffer through my hospitals policies--no matter how silly *I* think they are. They put their policies before me, it seems. I really like having the choice--it puts the power back in my hands.
I'm all for you having all the power and choice you can, beverly. That isn't just a sentiment.
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And for what it's worth, where I trained, we had a free refrigerator on every birthing floor that was kept stocked for the women at low-risk and all caregivers. Sodas, hard-boiled eggs, cheese, toast, fruit, snack crackers, jello, pudding, and lots of yummy stuff. It was only when women moved to higher risk that restrictions went into place. That made sense to me.
Have you done a walk-through of the place where you will deliver? Maybe they have fewer restrictions than you expect. (And maybe they don't. ) But I'll keep my fingers crossed for you. {--- for a full frig! Posts: 14017 | Registered: May 2000
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Of course, sometimes we don't have a choice of what hospital we deliver at, and don't get to choose the ones with "progressive" regulations. Posts: 21182 | Registered: Sep 2004
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quote:Have you done a walk-through of the place where you will deliver? Maybe they have fewer restrictions than you expect. (And maybe they don't. [Frown] ) But I'll keep my fingers crossed for you.
Is this addressed to me? Well, I will be giving birth at the same place where I've birthed three already, so I am extremely familiar with their policies. I really wish their policies were more like where you were trained. They just can't seem to let go of this outdated notion.
But things slowly change over time. After all, the jacuzzies were a new addition at my last birth, though I didn't get a chance to use them. I know that my Midwives are supportive of a more relaxed approach (like where you trained) but since they have to work at this hospital, they have to follow their rules.
Since there are no birthing centers around here and I don't want to give birth at home, this is my best option. And I really do like the place, all things considered.
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Hospital maternity wards are all very different. It was ice chips at the one where I delivered my first. (yet I did throw up in labour anyway)
In one hospital near me they had the most outrageous restrictions (ie. post partum mothers were not allow to carry their babies, they had to wheel them around in little carts. ) The other nearby hospital was much more relaxed. It helps to check out all the nearby maternity wards to figure out which one works for you. (EDIT: I should add I'm in Canada where shopping around for health care is a little less difficult)
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quote:(ie. post partum mothers were not allow to carry their babies, they had to wheel them around in little carts. [Roll Eyes] )
Ooo, they've got that rule at our hospital too.
Unfortunately, there really aren't any other good hospital choices for me. The one that is right next to this one doesn't take my insurance or my Midwives. The one way south is even more strict and stuffy and all the things I hate about older, more established, stuck-in-their-ways hospitals, and the one a bit north... well, that's a possibility. But I don't know much about them, and my Midwives don't go their either. Posts: 7050 | Registered: Feb 2004
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quote:ie. post partum mothers were not allow to carry their babies, they had to wheel them around in little carts.
Yup, they had that one at mine. And yet, they are rated the best in the area for a normal delivery-- because the other hospitals in that area are worse.
The only rule that really upset me was that they would not allow my husband to stay with me and hold my hand while I got my epidural (I had to get it on my side because of blood pressure issues.) I was not in a position to argue much, since every minute I tried delayed my much-needed pain relief (I was at this point getting 6 units of Pitocin, nasty stuff), and I hadn't made it clear before hand to my husband that I really wanted him to stay with me the whole time, including then (he's assisted on dog and cat surgeries of all sorts, and not the type to be grossed out by anything.) (I had mentioned it to my doctor, but my doctor wasn't there when they gave the epidural, just the anesthesiologist and the nurse.) I did ask why they had that regulation, and they said it was because they'd had husbands faint before. I said mine wouldn't, but they told him to leave anyway.
I cried. But eventually the pain relief kicked in and I was happy enough about that to let it go.
At least until afterward. Be assured, when they asked on the phone survey two weeks later what they could do next time to make my experience more pleasant, I brought that up (along with the water/ice chip issue.)
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That sucks. Luckily the midwives near me can now practice at all five hospitals within reasonable distance of me. I am still planning a home birth, however I needed to pick out a hospital to have my birth in case anything comes up.
I didn't register at either the hospital with the babies in carts thing or the one with the "latest greatest" electronic records system where appearantly one of your midwives spends a couple hours after the birth "entering all your info" instead of looking after the mother and baby. Posts: 251 | Registered: Apr 2005
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I guess we're still a bit in the dark ages as far as birthing is concerned. I expect things will be better for our next generation.
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Yeah, you're probably right. Things will get better. Midwives push for more "natural options" for low risk women and OBs are starting to listen. At the hospital I mentioned the Chief resident OB has said "the only one getting one-to-one care at his maternity ward is the computer" and is working to change it.
If only more of them listened.
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quote:But he knows himself well enough to take the precaution without anyone telling him to.
But still, they should let you have the freakin' @#$%@#$ choice!
Exactly! Especially since, as you said, people know themselves-- and their husbands-- better than the staff does.
They can always ask a husband to leave later if he's having a problem rather than kicking him out before they even get you in position.
Next time, he knows that I want him with me for the epidural, and he'll be ready to fight to stay with me if need be.
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KQ, you know, my son and daughter had cavities they needed filled this month. I was having my own mouth worked on while my son was in the other room.
The dentist came in and told me that my son was being *very* difficult. (The guy was obviously quite frustrated with my son.) He said he wasn't able to get anything done unless he got tough and pushed it. He was asking me if I wanted him to proceed.
I asked if I could be in the room with my son. The dentist was very hesitant. He finally told me that most children are *worse* behaved when Mom is there. I assured him that my son is amazingly brave, and would do fabulous with me there. He is not used to being alone, and that was what was scaring him.
Finally the densist relented.
My son was beautifully behaved from that moment on, even when I had to leave the room again.
When my daughter had her cavity filled, I was there the whole time (thank goodness) and she was like a dream.
The dentist laughed after it all and said that we always needed to be sure that I was in the room with my kids.
He had his own ideas, and thought he was right, but fortunately he was willing to listen to reason and be flexible as well. Posts: 7050 | Registered: Feb 2004
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Add to that the fact that I'm allergic to rubbing alcohol ( >_< ) and that the nurse kept forgetting it, and so I had to be the one to notice through my haze of pain that the anesthesiologist was about to prep me with it because my husband was out of the room... Posts: 21182 | Registered: Sep 2004
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quote:I asked if I could be in the room with my son. The dentist was very hesitant. He finally told me that most children are *worse* behaved when Mom is there.
I've heard this before too. It doesn't apply to my children either. Luckily my dentist is also understanding and allows my kids to sit on my lap while they work. He even let me into the OR until my daughter was asleep during her oral surgery.
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It is possible that one of the reasons why many Moms cause their kids to be even more antsy is because the Moms worry and concern for the kids is so thick in the room you could *taste* it. The Mom is tense and scared, the kids sense it, and it just escalates.
But I am a very calm person. And when it comes to "scary" things with my kids, I become even more so. Perhaps I instinctively know how my fear will effect them and go into overdrive to mask it. I act ultra happy, affectionate, playful, and the kids are more at ease than ever.
If they are bright enough, they will learn that those traits are signs of danger. Posts: 7050 | Registered: Feb 2004
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My kids sense my concern but they feel more at ease because they know I will be straight with them. If something will hurt I says so and help them brace for it. If something won't hurt, they believe me. I think part of the problem for some kids is that they expect dishonesty from medical settings. I find kids (and adults actually) do far better when they know what to expect.
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I was put under a general anesthetic before it was all over with my firstborn. Not BEFORE they got him out, but after, when they were trying to put me back together.
I couldn't keep food down until the next day, and hadn't eaten for about a day before he was born. At least I felt too crappy to be hungry. Posts: 9293 | Registered: Aug 2000
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I've never had kids, and don't have any nieces or nephews, nor have any close frieds who have kids. So, I don't have any personal experience with childbirth. That means I don't see the big deal about making it natural, getting feet rubbed, getting lotion, getting food, etc, etc. Not that I disagree with those things. They are just foreign concepts to me, you know? But all my experience is on the medical side of things. And I only had 2-4 weeks in labor and delivery experience in medschool so I don't have much medical experience either, I suppose.
So anyway here is how I look at it as a medical procedure (so you can see the other side. CT is more in the middle since she has more experience.) OBs see it all, you know. They see the easy deliveries and love them. But more and more often they see the complicated, high risk pregnancies. They see the tragedies and they eventually get burned from some case or other where things were supposed to go smoothly but then tragedy happens. It is natural for doctors to want to prevent more tragedies. The best way? Keep things nice and orderly and sterile and by the rules.
Bev, you say you want to be in charge. And kq, you think you know your husband well enough to decide he can stay during the epidural. The problem is, it isn't just you guys who are at risk in the labor process. If the doctor or the hospital lets the patient make choices, some of which are great ideas but lead to a less sterile, less controlled environment for the doctor, and then tragedy strikes, everyone loses. The doctor gets sued, too. Doctors HATE being sued. Trust me, I have experience. We do ANYTHING to avoid being sued. The doctor wants to maintain the control so he doesn't get sued and so that there is a low complication rate as possible.
KQ, did you hear about that guy who was holding onto his wife during her epidural, and he fainted and hit his head and died? The hospital and the doctor got sued. So now I bet there is another hospital who won't allow husbands in the room during epidurals. They are just trying to protect themselves.
I'm not saying they are right to do these things. There's probably a happy medium. Unfortunately patients and doctors will probably NEVER agree to the perfect setting for the perfect labor experience.
Malpractice insurance for OBs is through the roof, and that is because so many people sue. They sue for anything. Well documented, perfect deliveries also make the doctors' and hospitals' cases look better in court.
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If they had told me beforehand that he would need to leave, I would have done anything I could to keep them from making him leave-- including sign papers saying that if he was allowed to remain, we would not hold the hospital liable for anything that happened to him, me, or the baby as a result of him being in the room. (Heck, you already have to sign the part about you or the baby being injured as a result of the epidural, they could have written it right in to that! I would have paid a lawyer's fees to come write the contract, even!) But they didn't tell me this until it was time, even though I had asked, "Will he be able to be with me the whole time?" They said yes to that. I feel that was not completely honest-- not intentionally, maybe, but there you are. Posts: 21182 | Registered: Sep 2004
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Yeah, a whole bunch of wavers, that's the way to go, maybe. I was thinking about that. They'd have to have that all written up ahead of time. Should be fairly easy. Or maybe it's more complicated than I think it is. Also it could be that the "rule" was just the anesthesiologist's policy. It's his choice, basically, since it is his procedure.
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The anesthesiologist didn't seem to have anything to do with it; the nurses kept saying it was hospital policy. Next time I will ask and do whatever it takes to make sure he can stay.
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Personally, if a man is inserting a very sharp needle next to my spinal cord, I don't want him distracted in any way. I want him and the nurse with him in total control over the situation, and for that to happen, they need to know nothing will interrupt them, not a husband hitting the floor or even a husband who's curious and wants to lean over and check things out too closely.
Epidurals take, what - ten minutes max?
Hubby can take that time to go to the restroom, get some coffee, call relatives, etc. He can take care of all those things that he needs to take care of, but doesn't want to because when he's in the room with his laboring wife he wants to be totally focused on her.
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So it is the sue-happy people that are to blame!
You know, there are so many places where people can experience injury. Dojos, gyms, swimming pools. A lot of these places have disclaimers that the people involved are responsible for their own safety, and some make people sign papers that they will not sue for injury or even death. Whenever my children have had general anesthesia, I think they've made us sign something that made it clear that death could result and that we would not sue (I think.)
I am curious, could more doctors offices do similar things to avoid lawsuits? I hate our sue-happy society. Tragic things happen, and we have to blame someone *else* for them, even when there was no fault there. We all know this. Seems to me I'd rather sign a paper saying I will not sue than have to be restricted in ways I'd rather not be.
Let me take responsibility for my own life and safety! If the doctor really did make a careless, life endangering mistake of negligence, I can understand the desire to sue. But so many lawsuits are simply excuses to put the blame elsewhere. If I have been warned of the dangers of eating/drinking in labor, the hospital should not be held accountable if there is injury and death because of it. Just as I was warned when my son went under general anesthesia that he could die, and that I would not sue for it. I knew the risks going in, I took the risk knowingly, the responsibility is mine.
Could these things be taken care of at the time of registration at the hospital? (Hopefully done before the woman is in labor at all?)
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My husband was also able to stay if he wished, the doctor figured a paramedic wasn't going to freak out at the sight of a needle, but he left to do all that stuff that I mentioned, because it was a good time to do it - I was obviously busy, and in capable hands so didn't need him.
quote:So it is the sue-happy people that are to blame!
That's not all the reason though I don't doubt it plays a part. As CT said, you must remember that while you don't think it's logical to keep all pregnant women from eating on the small chance that they may need emergency surgery, the doctors HAVE seen women present with perfectly normal healthy pregnancies, and no reason to think anything would go wrong, and then wind up in the OR. There is no good way to predict who it will happen to and no one can look at you and say "You'll have no trouble delivering" and be assured of being 100% correct. It's impossible.
The doctors are indeed weighing risks - should I have everybody refrain from eating, or should I risk that someone will die from aspiration pneumonia that I could have prevented?
Ask yourself if your friend or sister died because she ate during labor, what advice would you give to someone going into labor? Now consider that doctors that have been through ob/gyn specialist training have seen multiple women die because of complications and have performed multiple emergency surgeries where eating would have presented a problem. Is it the easy way out for them to just blanketly prevent all eating during labor? Sure, of course it's an easy way out for them. Sure, most women could eat during labor and it never cause a problem.
But like CT said, it's not a question, to the doctor, of IF someone will need a crash c-section, it's a question of WHEN. And they don't know whether it will be you or the woman in the next room. So the safest course is to tell you both not to eat. It's not just the safest course for the doctor to avoid a lawsuit, but the safest course for them to protect you and your baby.
I lost my grandfather to aspiration pneumonia. I was told by the doctors there was nothing that could really be done once it was contracted. It's almost invariably fatal. I would hate to hear about a young mother dying from it soon after the birth of her child. That would be an incredible tragedy. Especially if it were a preventable tragedy.
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Belle's got it nailed, all right. Yep. Although, aspiration pneumonia isn't as fatal in younger healthier people. Can cause lots of trouble, though.
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quote:The doctors are indeed weighing risks - should I have everybody refrain from eating, or should I risk that someone will die from aspiration pneumonia that I could have prevented?
The point is, hospital policy about not eating/drinking while in the hospital does not prevent anything since most of these women likely come to the hospital with food in their bellies. *That* is my beef with this silly policy.
If all labor was a planned event where the women could come into the hospital having fasted for the previous 12 hours, well, wouldn't that be convenient? But we all know that isn't what actually happens.
Posts: 7050 | Registered: Feb 2004
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And there is another issue, one I almost hesitate to bring up. It may sound condescending -- if so, call me on it, please.
There is no physician who has been in practice for long that hasn't heard, "But if I'd really known what could happen, I wouldn't have done it. You didn't try hard enough to convince me." Gettting sued sucks. But letting down someone you care for who has put their trust in you really sucks.
So what do you do? On the one hand, there is what we do with children (who don't understand that even if it's painful, a broken bone needs to be reset, etc) -- we just do it anyway, "for their own good," with parental permission (or a court's if need be and appropriate). But kids are very very different from grown-up people who are autonomous agents and (rightly) should be in charge of their own bodies and decisions.
We don't just "do it anyway" to adults -- or at least, we shouldn't if at all avoidable (of course, if you are delirious and bleeding to death, you can't make that decision, so we make it for you -- until you can, ideally). One reason not to "just do it" is that physicians are only experts on the medical aspect of the situation. Patients are the experts on their own values and what a good life means to them. Having a physician make decisions for a patient means that doctor has decided that he or she knows better what is worthwhile and not worthwhile for that patient -- regardless of what that patient thinks.
And we know that physicians are often wrong about these sorts of decisions. We routinely underestimate the value of life to people who are disabled, we don't have some kind of special access into other people's brains and hearts, anf it's just plain arrogant to assume otherwise.
And yet, and yet. And yet there is how ashen you feel when someone says, "I didn't know. I couldn't have known. You should have known better." Not everyone will say that, of course, but you know some will. And you know that it's impossible to imagine how bad it can get, because it was impossible for you to accept what was happening the first time you saw it with your own eyes. It was like a war zone, a movie rated "X" for violence, a dream so bad it couldn't be true.
And if you couldn't believe it even when you saw it happen, how could someone understand it who never saw it?
But I'm not willing to take over autonomy from someone else, even if I think I know better. Not if they have strong feelings and reasons to do otherwise. I don't say "You have to do this" or "I won't let you do that" anymore. Not my decision to make. I do, however, urge strongly, give the soundest reasons I can, point to other accurate resources for more information, and use a lot of "I-statements:"
"I will be very worried about you if you don't do this."
"I'm afraid that X will happen, and I am afraid I will have let you down by not trying harder to convince you."
"If you choose to do Y, I'm pretty sure I'll be up at 3am worrying about what's happening to you. Of course, you have to do what you have to do -- but I just wanted you to know how concerned I will be."
That's about all I can do, I think. Really, it's the same as in any other interpersonal relationship: you have two people with different perspectives and different goals, sometimes which coincide (but sometimes not), each of which is working together to try to get somewhere better. All I can do (I think) is do my very best to be a good partner in that enterprise.
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I think surgeons often don't have the same bedside manner as you, CT. It's faster to just make rules "for the good of the patient."
This might sound condescending (CT's didn't) but sometimes ignorance is bliss. I can't tell you how many nurses and doctors and even my favorite biology teacher have told me that if they knew back when they were pregnant what they know NOW, they would have been petrified during the pregnancy and labor and taken their doctors' recommendations more seriously.
Ela did her nurse training after her pregnancies, come to think of it. I wonder what her thoughts would be on this subject.
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You see, I am all for free will and putting the power of choice in the person's hand. I enjoy doctors who treat me as an adult, who don't patronize, don't talk down to me. I love it when they treat me as intelligent enough to handle all the information (even if they have to explain some of the vocab to me. ) Quite often they will give me *strong* suggestions of what they think is best, but they leave the decision up to me.
And frankly, if I were to whine to this doctor later that they didn't try hard enough to convince me, they would have every right to look me in the eye and say, "I did warn you. You are an adult, and you made a decision. You are repsonsible for the consequences."
And to those who think they are grown up enough to take responsibility and later whine, they need to learn what being grown up and responsible really means.
Posts: 7050 | Registered: Feb 2004
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quote:The point is, hospital policy about not eating/drinking while in the hospital does not prevent anything since most of these women likely come to the hospital with food in their bellies. *That* is my beef with this silly policy.
If all labor was a planned event where the women could come into the hospital having fasted for the previous 12 hours, well, wouldn't that be convenient? But we all know that isn't what actually happens.
It's a matter of making the best of whatever situation presents itself. A woman coming in from the street with a full belly isn't the ideal situation. Just because that happens, though, doesn't mean that things can't be made more ideal in other situations. Most women who go through a hospital delivery labor for more than 6 hours in the hospital before delivering there.
Consider having your child in to have surgery on his throat (say, to have his tonsils removed). You could make the argument that some kids come in off the street with full bellies and need immediate throat surgery (say, have torn their windpipe in a car accident, or were running with scissors and jammed them through the back of the throat). Surely the anesthesiologist finds a way to deal with that, so why can't my child have something to eat and drink, rather than cry all morning with hunger or thirst?
But the anesthesiologist will turn down the surgery and make you reschedule if that happens. SO long as he or she doesn't absolutely have to do it right then, they won't -- not will anything extra in the belly.
This is despite having their schedules screwed up, despite getting chewed out buy administrators or tech staff for "wasting ER time," despite even making themselves or someone else to come in over the weekend in order to take care of the wonked schedule. It's that important.
I don't know any way of explaining why it is that important without actually showing you. On the other hand, I know how convincing "just trust me" is. I don't blame you for your irritation at the policy, that's for sure.
Again, I wish you a very safe and smooth experience, however you decide to handle it for yourself.
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Reminds me of the person who cheats on a diet and eats two cookies. Then says, oh well, the diet is blown, I'll just eat six more cookies.
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I worry, though, about how that tack of "doing it for the good of the patient" works out long term in issues of compliance and attitudes toward allopathic medical care. There are some good reasons why alternative and complementary practices have exploded in popularity.
What I want is good outcomes for my patients. Part of that is acknowledging that I don't know all about what "good" means to each of them. I also have to think about what the long term effects of my actions are.
Posts: 14017 | Registered: May 2000
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I will never, never , never forget the first patient I met who died of AIDS. I was a medical student, and we were to meet with some patients who volunteered to tell us their stories.
His partner wheeled him in. He was on oxygen, emaciated, but had a sweet smile. He wore a brightly colored t-shirt.
When he had been diagnosed, it was early in the first throes of the epidemic. The physician and nurse treated him like shit. When the med tech took his blood pressure and it was nice and low, she said "Well, we don't know exactly what you'll die from, but at least it won't be a heart attack."
It was a ghastly story, but the kicker was that the pain that was caused was truly unintentional. (He could see that from the perspective of years, but it cut deep at the time.)
He and his partner didn't go back to an allopathic physician for something like 5 years. Instead, he researched nutritional therapy, traveled to Mexico for shamen treatment, tried all sorts of stuff from all around the world. Macrobiotic diet, you name it.
Now, when I met him, there had just come out an "HIV cocktail" of retroviral threrapy that was really, truly, for the first time saving people. It required a lot of work and dedication -- there were dozens of pills a day -- but it worked for many. And my guy had all the dediation and strength of mind in the world.
But -- you knew this, right? -- it was too late for him. He already had progressed too far, and he wasn't strong enough for those meds, although he would have been an excellent candidate otherwise. So he was waiting to die.
How can we not take the long term effects of our actions into account? Save them this once, save their lives and save yourself time to save someone else, too, but lose them all when they say "To hell with you, Doc, I'm never going through that again." And they fly off to Mexico or drink herbal teas or what have you, and sometimes it's okay, but sometimes they die. And sometimes they die because you, you, you -- you let them down.
It's a damned if you do, damned if you don't kind of job. A balancing act on the ringside seat to humanity.
Posts: 14017 | Registered: May 2000
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Sara, I have actually never wanted to eat in labor--not that I remember. It is more the water issue that directly effects me. I don't see myself guzzling water either. But being able to swallow water--even just a few swallows!--is *so* much more satisfying than chewing ice cubes.
quote: But the anesthesiologist will turn down the surgery and make you reschedule if that happens. SO long as he or she doesn't absolutely have to do it right then, they won't -- not will anything extra in the belly.
But this brings it back to the extent of the emergency. If they can reschedule, it obviously isn't an emergency. But if it is an emergency, and life is at stake, they aren't going to stop because the child just had breakfast! Why can't it be the same for the few cases where a c-section needs to happen *now* or there will be death? So it isn't an ideal situation. Neither is the little boy who just ate breakfast and has to have surgery or DIE. It happens. That's life.
quote:Most women who go through a hospital delivery labor for more than 6 hours in the hospital before delivering there.
I guess I forget that labor tends to be this long or longer. For my last child, I was in the hospital about 2 hours before the birth. (No desire to eat whatsoever, of course.) But I had had dinner just a few hours before. If I had needed emergency general anesthesia, how much more danger would I have been in than if I'd had a snack in the hospital? Is there a significant difference in the danger? Is it worth it?
You know, it's funny, but almost *anywhere* you read about early labor (usually spent at home) they tell you to have a light snack, since you might have to go without for a long time in the hospital--and you will need the energy. This runs so contrary to the hospital policy/perspective. And yet the advise is pretty standard wherever you look.
I guess I still don't really see the sense in it.
Posts: 7050 | Registered: Feb 2004
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quote:I guess I still don't really see the sense in it.
I know you don't. I do, but I don't know how to share that effectively. Looks like we're at an impasse.
But I do respect your decisions. I'll just be a little extra worried, and I'll be a lot extra relieved when you post pretty picture of you and Porter and your new baby, and when you tell us how wonderfully it all went. Posts: 14017 | Registered: May 2000
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quote:It's a damned if you do, damned if you don't kind of job. A balancing act on the ringside seat to humanity.
That really sucks. I guess that feeling is going to come in any job that deals with life-death situations. What more could I have done? If I'd done this other thing, would they still be alive today? That is a horribly heavy burden to carry. Firefighters, emergency rescue teams, doctors, they all have to carry this burden. And it isn't fair, because if it weren't for them there would be a heckuva lot more death in the world.
Posts: 7050 | Registered: Feb 2004
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Helping a patient choose therapy should be like a partnership, with mutual respect. Patients just drink in education and rational explanations for things. I've had patients tell me they've never had a doctor take the time to explain anything before. Just order them around. People aren't going to change their lives, pay for meds, take them properly if they don't know WHY and don't realize the importance of it.
Posts: 1014 | Registered: Jul 2005
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When I went in for my surgery, they requested a urine sample as a part of the normal pre-op stuff. I didn't know why, but it turned out to be a pregnancy test.
The drugs they give you can be very, very bad on unborn babies, and they simply can't afford to take a person's word for it, even on the waiver forms.
The nurse said she'd only ever had two positives. One was happy about it. A little surprised, but married and prepared for it.
The other was TWELVE. Can you imagine the hairball that could have turned into if they had not done the test? Oy, vey. I generally don't question the 'rules' when it comes to stuff like that.
Posts: 9293 | Registered: Aug 2000
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Sara, thanks. And don't worry, if my birth was as quick as last time, I probably won't be eating or drinking in the hospital anyway. And with the wonderful sense of humor the universe has, after complaining so much, I will probably have to have an emergency c-section and will aspirate the previous morning's breakfast. But the hospital staff will sleep well that night, knowing that it wasn't their fault. Posts: 7050 | Registered: Feb 2004
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I did want to offer another perspective to take into account, that's all.
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) But I'll keep my fingers crossed for you. {--- for a full frig! ![[Roll Eyes]](rolleyes.gif)
) The other nearby hospital was much more relaxed. It helps to check out all the nearby maternity wards to figure out which one works for you. (EDIT: I should add I'm in Canada where shopping around for health care is a little less difficult)
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Can you imagine the hairball that could have turned into if they had not done the test? Oy, vey. I generally don't question the 'rules' when it comes to stuff like that.
