Tuesday, April 3, 2012

What to expect with an epidural

Ever wonder what it looks like to get an epidural?

If you're like me, then yes, you have.  I can't stand not being able to watch, so when my anesthesiologist asked if I wanted Leslie to take pictures of the process I was thrilled! He basically acted like he was teaching us how to do it and it was fascinating (even in the midst of all those contractions!).

Proceed with caution if needles freak you out.

Here's what happens:

First, you will lean over a massage chair with your face in one of those padded holes so you can breathe. It's like sitting backwards on a chair. Usually your spouse/partner/coach can sit in front of you for comfort.

the massage chair

Then the anesthesiologist will clean your back with a scratchy sponge soaked in an antiseptic solution like Iodine.  This will turn your back an orangy-brownish color like a really bad self-tanner and smell like a hospital.
After you are all scrubbed, they'll put a big plastic sheet over your back with a hole cut out at your epidural site (L3, L4 vertebrae). 
The next part is the worst, and by "worst" I mean not-really-bad-at-all.  
You will be given a shot of local anesthesia to numb the site where the epidural needle will be placed.  This burns/stings like a bee sting for a few seconds and then you don't feel anything.  If you are having a contraction when you receive the local, you will barely notice it at all. If not, it really does burn, but not for very long.

Next you will be asked to push your back out (really bad posture) and they will insert the epidural needle through which the catheter that will deliver the medicine will be inserted. You won't feel this AT ALL.

Inserting the epidural needle

Measuring how far to insert the needle

So cool!  There's just a needle chillin' in my back.

I don't have a picture of the catheter being inserted because it was hard to see that part, but after the needle is placed they will run a little catheter (just a little bigger than heavy-test fishing line) through the needle (like an IV).  Then they will give you a test dose of the medicine and ask you lots of questions about how you are feeling - do you feel hot or cold in your legs, etc. 

It takes about 3 minutes for the medicine to start working, but after that time you should start feeling immediate relief. If it is a good epidural it will take away all sharp and piercing pain, but you will still be able to feel a dull pressure during contractions and pushing but it won't hurt- you'll just feel it. 

The catheter has been inserted

Once it is determined that the test dose worked, they will tape the catheter all the way up your back and over your shoulder so they have access to it to give repeat doses if necessary.

All taped up so it can't come loose

At this point you are all finished!  They will have you lay on your back slightly tilted to your left side.

After you deliver, the nurse will remove the catheter and take all of the tape off of your back (at this point you will be really glad that you don't have a hairy back!).  

It will take a little while for you to get the feeling back in your legs enough for you to put weight on them (took me about 2 - 3 hours with my first one, and about an hour with the second).

You might be a little achy at the site of the epidural for a day or so, but that should be the only thing you notice.  If you get a crazy bad headache that won't go away or only goes away when you lay down, you need to tell your doctor immediately (even if it doesn't happen within 48 hours) because that may be a complication with the epidural.

There ya go!  I hope you found the whole process as interesting as I did. :-)

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