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Pain relief in labour and LSCS

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Transcript

Hello, everyone, I am back here again. I'm very excited to introduce the fantastic Nathan, who's come today to talk about all things drug related. Not in a bad way before you start to think what is it out and Nathan's a fantastic artist and a judge to four. So we're going to talk about drugs and pain relief and so first we always ask your best advice as a dead to a new debt. What would you always say? Right Well, I reckon get involved as much as you can really get your hands dirty from day one.

We can do that and lots of different loan it's not just good for you. It's good for you, baby. It's good for you want. Good day, everybody. Just roll up the sleeves. There's nothing that a dead night Apart from girl baby, girl baby Why would someone might be made to say Namaste that is before they before birth?

We do see quite a lot of ladies nowadays, talk about their options are either labor and all jizya. So maybe journals or anesthetics for severe general anesthetic, I'm gonna say old ladies. But there are some that wait till he came to say there's some people who perhaps content in a picture or for their labor, do like sit down, talk to them about what their options might be that would include people who have previous back surgery, or people whose blood doesn't clot properly. For example, very happy to talk to anybody who's had a previous and satisfactory experience, maybe journal or exam or is just worried about what the other one might go on. They are increasingly wanting to talk to the girls the skills and it's just practical implications of getting a sponsor or a be joking for later or severe and just, it's just harder. And so to be able to plan a little bit more talk about the options, get a timeline, and it's particularly useful.

And so if your obstetrician or we'd like things you should see in the midst of this, make a point wherever you're talking to them. And an emphasis actually adopted on you and it's like a specialty. Yeah, absolutely. specialty and all we do is nice, that is people spinals in general, is general anesthetic for anyone so you know, you're always may saying something quite good, very, you always make an elitist and obviously your surgeon. So let's all of the other support group. And so that an atheist role in something quite that is to offer pain, right?

Yeah. So during us this area, and our role is to make the procedure comfortable and tolerable for you. And this Finally, really three ways we can do that. The other thing that we do is sought out your pain relief afterwards. Few hours, days, weeks, will charge all that. So you're in charge of that as well.

We're in charge of starting the ball rolling. Yeah, we can do about it having a plan and often, if there are problems later on with pain relief in the last month, give us a call. Okay. So and you obviously make sure that the Bloods are okay as well, so that the doctor might have done the buttons, but it's your that you're interpreting that in terms of the medications? Yes, yes. So whoever requested that should be following up as well.

But having a look at those and making sure that it's safe to go with the procedure. Safe to whatever family? Yes, that's great. And I guess also the moms to know that before they have any procedure. They always signed a consent. So sometimes that if you know that maybe the moms a bit nervous about a spine when the city for example vs. arion thing Maybe guys Bailey in a fitness beforehand, so they get all that information.

Yeah. And there is this part that they sign that they understand what you said. Yeah, that's right. So we'll certainly talk about the pros and the cons and make a suggestion. What anesthetics best for you? And then ultimately the choice is yours.

Yes. as a as a patient, you can choose to accept or choose an option, and then will not get you to sign so that we've talked about it. Yeah, absolutely. So and it's always, you know, completely your choice, a great discussion to have with your care provider, whether it's gonna be black with a doctor about, you know, there's some people I find that are very anxious about anesthetics, and maybe they don't want needles. Or they've had a bad experience before and you know, having a chat with you on a nice bright sunny day and not stressed and anxious. They can get lots of good information.

Yeah, so that it doesn't seem as scary. I think so. Yeah. I think importantly as well, if you have a child early on, you can put in place some other plans. If you need all five big, getting a therapy Mark just convention for you get to see the therapist early on and spend some time with them, you're not going to lose anything and it might not make a massive difference the rest of your life, not just labor and delivery. We can also do things like with numbing cream on if we plan ahead.

Be more comfortable with labels. Yes. And just inform you what's going on. And to kind of maybe demystify some of the the information that comes out there and like one bad, terrible outcome can make media all around the world. And you know, the percentage of that can be incredibly small, like something like, you know, permanent nerve damage. Yeah.

So that's fabulously rare. I guess as far as permanent nerve damage goes to put it into a context there is a chance with the N AP German particularly also with a swan over, but your chance is something akin to your chance of dying in a car crash lighting for you. Amazing lower if you get in your car driver and you don't know about that today, it's going to happen to use bondable. Europe in general is essentially from a damage point of view. So we're talking, wanting 50,000 200,000 something like that. Nice, but but it does happen.

Yes. And that's the part of that information sharing him so that they understand a lot of medicine especially is just trading one bit and then going away and basically one you can see it from start to the end. That's right to one job do nothing else until that's finished your property. works for you. Yes, Nathan's got lots of lots of chit chat to get you through as the there ain't no problems we can talk about anything. I love taking photos of your baby as well.

Yes, for particular with the angles actually. Sorry, in terms of an epic year oh and as final. So, we know that we can see you beforehand, but it's No, you know, we're going to come in and get it done and how long would you expect that and as final versus Aaron would go for. All right, so the process for the severe in the spotlight will be coming to the operating theatre. And for a lot of ladies, that's the most unpleasant part of the whole process tomorrow so pop that in, then want to acquaint you back with some aesthetic gotta get you to sit up and kill off a little bit of a debate like this. So kill of the back not not really a link from the hip to kill.

I'm gonna put a little bit of local anesthetic back just another patch of skin at the top here. And then through that is really really fun later many times final blood taken me pops medicine and take them anywhere it starts working straightaway. Probably takes about five minutes to work fully in which case you'll be comfortable optimum after that he catches but be able to move your legs okay. You might feel any it might feel pushing and pulling emotion. I think most ladies will feel some sensation yeah baby should never feel. Yeah.

If you're not happy with what's going on in plenty of time just jealous and was done sorted out there will always have the time to stop. If you're thinking takes about an hour people take a beat and spinal anesthetic will start to wear off about a half to two and a half. Just drift away. guess it'll just drift down so you get feeling back which lay your leg strength and come back. There's probably six to 12 hours until I can only go so enjoy the first day up to zero and rest in bed which fade out Yeah, then the next day you have to be up at a big enough and really be comfortable and get ready to get out of here. Otherwise Yeah, potentially rapid.

Yeah, yeah, it's fine. To keep all that blood moving and deep breath and be comfortable to do that, so take some time away for the first couple of days at least. Yes. And I guess, you know, thinking about what your body does, you know, if you accidentally got your foot stuck under a chair, like, like you would get this instant message to you, Brian saying, yeah. And very, that doesn't alter the pain message when you have a severe and because your body's like, excuse me. Yeah, that's right.

So so you will have some discomfort afterwards. That's just a fact. And everybody responds to that differently. And the amount of pain relief, very, very painful watching them, what your experiences, are you hoping there'll be options out there, but you just got to take something from the ceiling panadol four times a day plus an anti inflammatories is a bare minimum. On top of that there'll be some stronger options. If you're just asking me why for Yeah, it's always good and bad with over them.

It's always a balance. You know, sometimes a really strong narcotics can make you feel really sleepy and some people don't like that feeling. Or some people really like to be on them forever. But it's about knowing that it's more important that you may think about when you can expect to do that without some sort of medication at all, for at least the first couple of days. You really need to be taking something decent to get up and get moving. Yeah.

And after that you can stop wanting back in. Yeah. And the strongest stuff has the potential to come out and reverse smoke a little bit. But really the amount in your mind, your brain is similar to the Matthew Briscoe, so you're taking it to new knowledge, drowsy and semi conscious then there's not enough breast milk to fix you. But if you're taking sensible amounts of pain relief steps to be comfortable, but not sedated directors, and knowing that, at that stage, you've actually got very small amount of colostrum or breast milk as well as Then you think of the relative percentage to that as well. It's it's really risk benefit.

But then the amounts are very, very small. And, you know, if you weren't moving because you weren't taking pain relief, the risk to you for that is actually worse. So, we're always balancing and you know, people will explain that to you because you know, you spend the whole pregnancy avoiding medication or somewhere. But, you know, in that kind of scenario and situation, there is a reason why we need to tell that message that your body's saying this is really sore to just calm down a bit, which is why we use that combination of a paracetamol which is going to make everything last longer. And any inflammatories we can't use in pregnancy. And because it can affect the little hole in the baby's heart that we want to keep open, but once the baby's out, we don't want that anymore.

So unless you've got a medical condition where you can't take an anti inflammatory, we would use it My post bed as a better pertain, in fact, it's one of the hyperlinks, yes. Because there's a muscle involved. So you want to just comment down a bit, and then maybe some sort of a stronger painkiller to balance everything out. Yeah. Which is great. And some people even after normal bit, use the combination of those painkillers because there's lots of soft tissue, Eg apparently that can be quite tender.

And then in terms of postnatal medications, that's kind of the three types that we tend to look at using. Well, if you're, if you don't want to have a spotlight, the city can go to sleep. So there's only three alternatives. To get through a scenario in the spotlight aesthetic. You've got an AP journal in your library, you need to struggle through that. Then there's a general we don't never suggest a general anesthetic as your primary anesthetic.

Because it's not a sight from others. yet we're principally looking after the general anesthetics very sight nowadays about a song or a feature. I always suggest if you just want to have a small organic job and a general audience has a reason you can't have a spot for the job, then you might get an agenda. Always just for your safety. Tip, Gerald. Sorry.

Lots of people think they have some people like, I'm not gonna say how come I'm going to happen straight up. So it's still you will recall. Yeah, so the nice to this law is putting up general in and then run up the orders for it. And then midwives are trying to carry on with those orders. Yes. 60 $50 an epidural and management in conjunction with the patient and call the least of this audience come back Is this okay?

And is it because you explained that the spine or you kind of care a lot that maybe a little bit a lot numbing and then the needle goes in? It's very much like that very similar? Yeah. So it does take a bit of time. So firstly, from the time you call for Namaste, that is the paranormal. Constable is one day waiting for you.

Jimmy not doing anything else I'll be there straightaway. Problem hospital I probably gonna have to come in from home. And then it's gonna take at least 20 minutes by the studio 40 General to be in and start to work. So the early messages if you really want a journal, talk to midwife about it talk to your obstetrician about it. If you think you want coverage as early as you can, because it's got a tight lipped sign that was it comfortable. Yeah.

Okay. And they are really pretty simple to get in most of the time, there are some practical challenges and you'll want to see the bigger ladies are the harder they are to have to deal with it. You take a bit longer to get there. Because it's not like if you're putting a drinking because you can't really see this but it's a little kind of a blind procedure. I feel sorry, place to live for generally grateful until we found a perfect spot. At a time little political capital and then stick it all down for you okay to lie on that afterwards sticky type although the effects we don't want to pull it out there's not homelite down No I am making around and is that much type not going anywhere I find a need that is the quantity killer with how they like things to be down.

Yep, that taking the epidural that when you don't know it's entirely different just a huge bandaid coming off your back it was nothing like putting it in psychokinesis so wanted 200 ladies will get about here they block a migraine afternoon journal. And sometimes that'll need to be fixed with another at the children a couple of days. Blood patch does that one in 200 that's, that's really irritation because going to Vegas slept for two days to a week. But once again, hundred 99 200 Come on get that and if you think about that in a normal size maternity unit that you know, one a month if that you Can another thing about the journals there Thompson and a petrol is recommended to nutritional advisor that uses other than just making you comfortable control with the blood pressure surges that you get with the contraction so if you've got a problem with blood pressure like significant preeclampsia which might save you and having to have a conversation with them about that about wine cheese for taking the glass half full had been cut off on anything anything.

Yeah, so some people if you obstetrician on with right now you just aren't gonna cope well with with a live as I might suggest. Yeah. I've seen a lot of people out there. Yeah, I know. Often who's gonna cry? Yeah.

And sometimes you just hope people think that and make that so sitting in their living space ready to commando down and you're like it's the Friday at five o'clock. Yeah. So there's not going to be any name for this anywhere. You're going to get really cranky with me. We got cool ones. Yeah, if you call it peak hours just going to take a long time to get there unfortunately yes and there's also in some cases with a difficult birth or twinsburg that the doctor one some sort of a feature on their onboard ready to use for significantly obese ladies with more and more putting in earlier it's just so much harder when the woman around in labor challenging procedure anyway just to find a perfect spot in the larger girl.

More lucky to have this daily no sighs I had that in ready to go in case as a syringe provided great comfort for the ladies. It's often the plan now that's not always to create. Absolutely. And you would generally have had that chat with the OB say well aware of a one in 1000 ladies will have a temporary irritation of American made back Okay, back in back I know what causing somebody numbness or weakness in the midst of time compaction relates perhaps I could play something with this Yes, that's right. So one of the things will have that that gets better takes days or weeks to get better, because it's one of the thousand necessity for significance. It's not like you know, the risk of having a car accident once here in Adelaide doesn't stop you driving around?

Absolutely not. So you'd have to kind of really put that in perspective as well. And, and reactions to if he draws and finals, they very many with regards to AP journals most work really well. As far as reactions go both an AP journalists bottle will cause your blood pressure to go down to a certain extent so will miss your blood pressure often by both going and if you don't feel fabulous, just feel that it's usually quicker for you to tell your nieces or something. Yes, than it is for a blood pressure cuff to think about it. Yeah, and that's easily fixed.

He was going to drop in to find some fluids or some medicine. So that's, that's common temper. And we've kind of already had a bit of a chat about the postnatal medomak medications and the fact that you might start off stronger and then certainly when you go home, you get some education and awareness about your head weighing down on those things, but it's not like maybe when a doctor prescribes you of course of anybody can you think I've had to type them all that my postnatal medication, any inflammatories and certainly got side effects and parastatals fairly face but you're stronger pain killers, you know if you don't need them, you don't keep taking them because backup prescribe to you. You just wipe them down. You take them when you need them and if you don't need them, don't take them. So do it.

There's not a fix me but no real chance of getting hooked on them if you using them as suggested and stop using them when you don't need them disappear. And if you feel uncomfortable having some of those more You know, kind of narcotic based medications at home, and you've kind of still got some left, you can always pick them back to your local pharmacy. Yeah. And I'll dispose of them safely. Certainly the strong painkillers, we don't encourage you just to put in the beam. Because you don't want someone to come across them.

So you know, safe disposal IV medication. Yeah. You don't want to leave things on that line right in the cupboard tricky to find. Once you finished with him, take him back to your pharmacist. And now do it properly or even think Oh, I remember those drugs I had when I had a baby. Four years later, I've got a sore neck, I might take some men dying, and probably good to go back to the doctor and get that checked up and dying and don't share as well.

I do find that some there's a bit of a climate of meditation sharing amongst some friends. That is quite worrisome, actually. Because, you know, what did I had the other day someone said I was going to be anxious. So my friend gave me her antidepressants and I'm like, Oh my God. Don't do that. It's not safe.

It's not sensible. It's probably not legally. Just don't just do JP Yeah, absolutely. And get that advice just for you, especially with with the payment medication. postnatally. Well, that's fantastic.

Thank you. It doesn't me. You know, for a lot of people, this is the thing they asked all of their friends about. They look it up on YouTube and Google it, but they don't take that easy step just to meet within a Methodist and whether it is you that come or someone else there's always a report written information that's available on your file. But in some cases, just knowing you know the basics of what it is is going to help you through to not be stressed and anxious and you can enjoy the birth of your baby. A lot easier.

Happy to help with that today. Well, thank you. Thanks for coming. That was excellent, really, you know, very calming and hopefully you get nice is amazing and Thanks for the question.

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