#epidurals

Today is an epidural day at pain management.

Please include me in your prayers.

The last doc hit my spinal cord, giving me occipital headaches, and my pillow felt like a cinder block. Now, I have lesions on my spinal cord.

So I basically have one side of my back with full pain no sciatica, while my left leg is killing me. :/ at least I’ll have an epidural for fall. Now that I know there’s a limit I will better plan them out. At least one leg is not experiencing shooting pain. If the door block proves to last longer I may also try and work out having them both done in a staggered way to do both plus my regular epidurals.

I guess I’m lucky I don’t have a needle phobia. The injections suck but it’s worth it; there’s enough pain relief to make the momentary injection pain acceptable. Also in the back of my mind it in some ways asserts my pain patient status. Like who would go through injections on their back if they were not truly in pain. That sort of internal ableist notion that when you have official diagnosis and regular treatment then your pain really is real and you can prove it others and yourself.

A lawsuit was in the news recently about a Kentucky doctor who refused to give his patients pain medication unless they had epidural steroid injections.

Really? I have run across this scenario many times throughout my 32 years of performing complex spine surgery. It is a huge problem from several perspectives.

First of all, epidural steroid injections don’t provide lasting relief for any indication. This is particularly true when they are recommended for neck or back pain. There is not any research paper indicating a significant benefit. Yet they continue to be administered at a high rate.

I prescribed them sparingly for acute ruptured discs, where the natural history is for them to resolve without surgery most of the time. The steroids do knock down the inflammatory response that occurs around the disc material, so it buys some time and sanity while the body heals. I also used them occasionally for spinal stenosis (constriction of the nerves). Pain in the arms and legs would usually improve for a short period of time.

What was unexpected was that many patients that I had on the schedule for surgery would cancel because their pain would disappear when they utilized other tools to calm down the body’s stress hormones. The more favorable hormone and chemical environment changed their pain threshold.

Epidural steroid injections as a stand-alone treatment might be of some benefit, but they aren’t going to definitively solve your chronic pain. Whatever benefit that a patient may feel probably comes from the systemic effects of the drug. Steroids make everything feel better, but it’s unfortunate that there are so many severe side effects. (Read more at link)

In Ohio, women under 18 who are in labor cannot consent to their own health care. They can receive emergency services, but nothing considered to be elective. For the many Ohio minors who become pregnant, it's a painful gap in coverage.

It's also complicated by the fact that in Ohio, there is no legal process for emancipation: a minor's parent's must be deceased, or the minor must be married or enlisted in the armed forces to be granted independent legal status.

When the hospital wouldn't authorize an epidural, Sweeney called Children Services, because often time a children services agent can sign for medical consent in these cases - but it was 3 a.m. The young woman was in active labor and an agent couldn't make it to the hospital until 9 a.m.

Sweeney remembers how hard it was to tell her patient the news.

"I had to go in, sit down with her and talk about the fact that she wasn't going to be able to get an epidural, and she was going to have to do this naturally," Sweeney says.

That's when the woman broke down. Sweeney says she folded in on herself in tears.

PF = Pelvic Floor

Women in agony during labour are being denied epidurals by the ‘cult of natural birth’

[ad_1]

Women in agony during labour are being denied epidurals by the ‘cult of natural birth’: Minister pledges probe as NHS ‘ignores guidelines’

Health Secretary Matt Hancock has said that he would launch an investigation 

Six NHS trusts identified as refusing pain relief when women in labour asked

Women have complained they were being told that ‘it’s meant to be hard work’

By Abul Taher and Ja…

Taken from /r/askscience/

Taken from /r/askscience/