Friday, June 28, 2013

Obstetric Anesthesia: How I Share Your Pain

This is a spinal anesthetic; the anesthesiologist has pulled the stylet and is looking for a drop of CSF at the hub of the needle. This confirms placement is correct and injection of local anesthetic can go in.


I do anesthesia for women who are in labor and having cesarean sections.  I support women's medicine for the entire day I am 'on call', offering emotional and Reiki/spiritual support as well as the removal of pain of surgery and having a kid.

I hurt.

I feel your pain.

And after you are done and ecstatic over your newborn baby, I drive home somewhat in a fog, anxious to go to sleep. I experience sleep deprivation just like you with your crying baby--only for me it's the phone in the call room that wakes me up instead.

Sometimes I wonder if our Guides and Angels get as tired as I get,  after helping us to get from 'here' to 'there' in our own growth and development.

Here are some of the ways all of us on the Labor Deck, not just the anesthesia providers (CRNA and MD) support you in ways you might not realize:

  • The ward clerk and doctors office sees that all of your important medical information is sent to where you are having your baby so everyone will know your needs precisely for this delivery.
  • The nurses carefully assess you and gather information for your current state and document it for the team, things like drug allergies, medical history, and obstetric history.
  • The lab checks your blood for me to see if it is safe to put in an epidural or spinal for labor (not enough platelets, you can get a blood clot in the back that can paralyze you)
  • The pharmacists make sure I have plenty of drugs to use to control your pain in the supply area.
  • Emotional support begins with the nurses and they explain to me your 'situation' so I can react accordingly.
  • Each of us on the care team makes it a point to communicate with face-to-face contact that 1) I'm here    2) I care about you     and    3) I know what to do to make you feel better
  • The above statement is from the work of Charles R. McKay, MD FACC FAHA, based on his work with Heart Failure Patients. This face-to-face is a direct factor in promoting good outcomes in patient care.
Sometimes when it is busy all of us feel like we are taking care of all these hungry chicks

In Spirit:
I offer myself to you in service with all of my gifts. With my intuition, combined with my experience and the teamwork/pooled intuition of the nurses, we have a pretty good idea if you are going to 'go' with vaginal delivery or need a c-section. We might try other things to 'help' it, but many times the 'data' point in that direction long before we ever mention it to you. We give you 'your chance' to go naturally.

I take in all this 'information' on your energy and emotional state, and adjust how I interact with you to make it more effective. For example, when Spirit guides me, 'give the Transition symbol' while I am with you, I give it. For example,  I give a lot of Reiki while I hold you leg while you push. I also pray throughout the labor and delivery for both of us, for things to go as smoothly as possible.

In Emotions:
As an empath this is where I take the damage the most. When you are panicking, I feel it just like you. I do my work, but I have to be careful to take only 'what is mine' home with me at the end of the day. 
This is why I take a bath or go to the ocean the day after--to clean all the residue of these emotions I have been in 'contact' with off.
I make it a point to smile and to be pleasant when I am with you, even at three a.m. It's not your fault or the baby's that we are working when both of us could be sleeping!
I also do not wear makeup so you will be the beautiful one and be comfortable while you are with us.

In Professional Capability:
Sometimes I 'dig deep' to deliver the care for you. The spine isn't always 'textbook'. I have to make minor adjustments in dose, approach, and equipment in everything I do. There is a ton of information I must enter into the computer about what I have selected for you and what I want the nurses to give, and what I have given and how. My job is to make it look easy, but between us right now, more often than not, I sweat a little, and sometimes my knees wobble over the difficulty of what I have been asked to do. 'An epidural' sounds simple, doesn't it? But to me, it is often like Luke Skywalker using The Force to get those shots into the Death Star at the end of the first Star Wars episode. (Most pain doctors do this procedure with fluoroscopy --x-ray movie--visualization).
I also communicate to the team effectively about what I have done and make sure that your clinical needs are met after I finish with my care.

In Physical Capacity:
I am hungry, often times. I am sleepy. I am sore. I have a sore back from reaching over the bed. My muscles get a workout trying to get the needle through the calcified ligaments in your back sometimes. I might have just sat down to eat lunch when I am asked to come 'fix the blood pressure' or 'give an epidural'. My feet and legs ache at the end of the day. I might, when it is late at night, want to brush my teeth, but I am in the middle of procedures and I can't do that. Many times we have to void and there is no time so we are 'holding it' until the next chance we can get to empty our bladder!

In Mental Fortitude:
Sometimes we have just had something challenge us and you are the next one. I have to tell myself to 'pull it together' and 'move on'. Sometimes I have to focus for the entire team, and be a leader when there is massive hemorrhage and I am giving lots of transfused blood. Sometimes the nurse you have has written me up in the past (they do this OFTEN! Even me! LOL), and I know it, and I don't want to be working with her but I am, and I have to 'buck up'. One of the hardest ones is when technically my work is 'a challenge' and I would like to quit but there is no back up. I have to keep trying until I get it in and get you comfortable. Sometimes I have to come back and take it out and do it over to make you comfortable. It is all in a day's work, but you wouldn't know this; having to explain this to you takes a lot of mental strength on my part because you and I simply weren't expecting any difficulty in the first place!

How Spirit Helps:
  • The team invited me to buy dinner with them, but I declined.
  • Five hours later, when I was hungry, a nurse offered me a slice of her leftover pizza and a ward clerk shared salsa and chips.
  • I get woken up in the middle of the night with a message: God has JOY! 
  • Enough time is 'cleared' for me to take the yoga class offered free at work--in my scrubs!
  • A song kept playing in my mind, all day, all night, and then the same one came up on the radio 'out of the blue' to comfort me. Here it is--above--see Coldplay's Chris Martin?
How You Help:
  • Your trust
  • Your smile when 'everything works'
  • The gratitude of you, your husband, and your family for my work
  • Your being yourself so I can see the 'spark of God in you'--sometimes it can be your carefully put together hair, your pedicure you picked out to make you look your best, your laugh and joking personality, your curiosity about 'medical stuff' and wanting to give back a lot by just being 'who you are'. I find it refreshing how 'different' every mother, father and baby is.
  • Your little gifts for me or the team (we appreciate it VERY much)
  • The look of relief and joy when I check on you the next day.
It is an honor and a joy to be there with you at this special event in your life. 

Even if I am worked to the point of pain while it is happening. 

We share that pain, together, while new life is being welcomed into this world!


Reiki Doc