So nervous about having the Spinal...

[Writerwannabe83]

I'm having a CS in a week and today I had my appointment with the anaesthetist for my pre-op chat. We spoke quite a bit about the spinal and he said that I'll feel numb from the chest downwards and although I knew this, it has suddenly really freaked me out.

I'm so scared I'm going to get myself into such an anxious state about the sensation of being paralysed. I'm panicking that something will go wrong and I'll never get my sensation back. I didn't think I'd be this nervous but I'm feeling really scared.

Can anyone reassure me that it's not actually that bad??

[omri]

Congratulations writer! Was thinking of you over the wkend. Enjoy your gorgeous new baby boy

[Lottiedoubtie]

congratulations!

[secretspy]

Lovely, congratulations!

[Writerwannabe83]

Thank you everyone!!!

Being numb wasn't particularly nice but the Spinal itself wasn't anywhere near as bad as what I thought it would be!!

Little boy arrived safely on Friday weighing 8lb 7oz - he's amazing!!!

[Lottiedoubtie]

Good luck

[AuroraRoared]

Good luck Writer!

[Writerwannabe83]

Well today is the day and I have been lying in bed, wide awake since 04.30am worrying still!!!!!

I just can't wait for it all to be over and for me to have my little baby!!

Thank you everyone for your kind, reassuring words!!!!!

[shouldnthavesaid]

By the by, I had mine on a Friday at 5pm (the second one) and was fine. I was one of only two patients on the ward and as such, things were much better than on a crammed Monday morning etc

[shouldnthavesaid]

I've had two for vulval - vaginal procedures. Both times I was absolutely terrified but it was fine.

The first time I was given long lasting stuff - bupivicane plus lots of painkillers - so was numb for around about 12-14 hours, due to the extent of surgery. I remember sitting pushing my bum out so they could see my spine easily, and having the needle put in, then losing sensation from my toes upwards. It's a lovely cosy feeling. It panicked me at first but everyone was very reassuring. I didn't feel a thing, I watched them doing major vulval surgery and was laughing (I was drugged out of my mind) as I couldn't feel it.

Things did go wrong that time - I had a horrible reaction to the sedation and became delusional but even then, they didn't panic me unnecessarily I'm told. They just held me gently, increased the staff involved and when needed, gave me different meds into my hand to help me. No worrying involved by anyone except me. I thought they were trying to kill me.

The second time I had short acting stuff plus morphine. I did go numb, from belly button down. It didn't work well at first so lots of wriggling around - at one stage they lifted my legs and sort of pumped them back and forth to get it moving. Very funny - again, I was drugged. They sprayed my tummy and foof with cold spray to check, every few minutes, if I was numb and ensured me that they had everything they needed at hand to knock me out if I needed it.

When they put the injection in I had the anaesthetist behind my back, the nurse at my side, a nurse on the other side and my surgeon crouching on the floor talking to me and going through breathing exercises with me.

I remained wide awake and very relaxed and cosy - lots of blankets and pillows - and had a lovely anaesthetist who held me in a hug the entire time (45 minutes) whilst talking to me about random rubbish.

The room does get busy but everyone should introducer themselves to you. A lot of operating theatres have a radio or similar which helps too.

Just think, you'll have a lovely squishy snuggly sweet smelling baby at the end. I came out with thirty fanjo stitches and a cauterised urethra the first time and a coil the second... I did get a hug from the anaesthetist, my surgeon and nurse but nothing beats snuggly baby cuddles!!

Recovery was fine - spinal wore off by bed both times, I was able to walk tentatively (though needed the support of nurses for the first twelve hours both times) and was eating within an hour. In the actual recovery ward I got a lovely glass of water both times as well as painkillers and anti nausea/heartburn stuff.

Just don't do what I did - in my confusion, the first time around, I threw an oxygen mask across the room, screwed up my hairnet, broke a pulse oximeter, shouted at the staff, tried to instruct the doctor on how to do a good running stitch!, sang about sewing, and then tried to climb down from the stirrups myself whilst talking about what I was having for lunch! I certainly made everyone's morning entertaining!!

[JRmumma]

I saw it writer and i thought that woman was amazing.

Just remember that she had the option to go under GA at any point and that although it didn't work 100%, she was still within a very controlled environment and in great hands.

[Raxacoricofallapatorius]

OP, read this recent thread.

I know you're worried, that's normal and I think you're focusing all of your worry on the spinal. Read the above thread. There are hundreds of CS done every day and as that thread shows, the vast majority of them are very positive experiences. I'll also copy and paste CS advice I've given before...

"A cs is nothing to worry about. Really, it's not scary. More than anything it's just weird. You'll have brilliant staff around you who do this many times a day. Their priorities are you and your baby and keeping you safe and healthy. A cs is not the poor cousin of a vaginal birth. You have choices within what's happening and it can be as positive and life-affirming as a vaginal delivery. You can choose your music, you can have the screens lowered at the point of delivery, you can have skin to skin straightaway. My DH even watched my second cs from beginning to end. It was a quiet, calm and very positive experience.

Everything will be explained to you first, you'll meet the surgeon and the anaesthetist well beforehand and they'll let you ask any questions but a quick run through...

Like I said, it's more weird than anything else. You'll be trussed up in support stockings, cannula in place and then you'll have the spinal put in. You sit on the side of the bed, hunched over a pillow, sort of pushing out your lower back. They'll give you some local anaesthetic which is like little bee stings and then they'll do the spinal. You can feel some pushing and pressure and the actual spinal taking effect feels like somebody pouring water down your legs. You'll then have time to lie back on the bed before the numbness sets in and you won't be able to move from about your chest down. You can still move your arms though, but they'll tuck them in under a sheet to keep you still and warm. Your anaesthetist from this point stays above your head, will talk throughout and will generally, ime, be lovely.

You'll be wheeled through to theatre where they'll check you're totally numb and do a little bit of prep. They will talk to you and tell you what happens next and then they'll start. They'll put in a catheter too but you won't feel that. There is no pain whatsoever but you can feel what is happening during the actual removal of the baby. Somebody once told me it feels like you're a handbag and somebody is rummaging in you for some keys. This is SO true. You do feel pressure and pushing, right inside you and up into your chest. From incision to the baby being out takes a couple of minutes. Really, it's very quick indeed and soon that baby is appearing over the top of the screen. You'll be so preoccupied with the new baby, you can have cuddles and skin to skin, you won't really be aware of the rest of it. It takes about half an hour to finish stitching all the layers but it whizzes by. You might feel odd, intermittent pressure on your legs. They put these self inflating boots on them and they encourage blood flow and circulation. It just feels like somebody squeezing your lower legs a bit. Apart from that, you'll feel v little during the stitch up.

Then you'll be wheeled into recovery and you will be looked after by a member of recovery staff but your anaesthetist will stay for a while too, just to check you're okay. You'll have the baby tucked in with you at this point and you can bfeed if you want. They'll give you some water too. You'll have a drip up rehydrating you (you'll have been nil by mouth for a while) but that first drink is lovely. You'll find too that you can move around by now. You can wriggle your feet and bend your knees and normal sensation returns really, really quickly. No pain though. They usually give you some morphine into your cannula and a suppository once you're stitched so you're painfree once feeling returns. Of course, if you have any discomfort, ask and they'll sort you out. I found I was quite chilly in recovery and also the spinal/morphine can make you a bit shaky. Plus all the adrenalin is rushing through you. Don't be scared if you feel shaky at all. It will pass and the anaesthetist can give you something to stabilise your blood pressure then too. You may be fine but it's worth knowing that you can feel a bit wobbly.

Once they're satisfied you're okay, they'll wheel you back to the ward. All this time your baby won't have left your side and it whizzes by so, so quickly.

They will encourage you to get up fairly quickly. Few hours post op if you can. I had ds at 3.30 and was up and sitting in a chair for dinner. It is best to get up and move around a bit as soon as you feel able.

What else?

You might have to self inject blood thinners for 7 days as a precaution. They're rolling this out in all hospitals but it isn't everywhere yet. It's fine, they'll show you how.

If you need pain meds (I never did), take them on time and don't let yourself get uncomfortable first. They'll probably give them to you and you can administer them yourself instead of having to call for them.

If you get pain in your shoulder, like you've slept oddly, it's trapped air from the op. It's common and your bowel will be a tad sluggish at first so you won't pass wind normally on day one. Peppermint capsules in water will remove the discomfort SO quickly. Just ask the staff.

They will monitor urine output before you can be discharged. You'll have to do your first 3 wees post catheter removal in a jug and record the amounts (you don't have to show anybody).

Catheter was in for about 6hrs post op for me both times. Soon as you can get up and use the loo, they take it out. Totally painless.

The earliest they tend to discharge is day 2, with day 1 being the day of the op but most places keep you in 2 nights as routine.

When you stand up at first, it'll feel like you're going to tear. It's just an odd sensation, not painful. Do stand up straight though and try not to hunch and shuffle. The feeling will pass.

Wear big cotton knickers which don't sit on your knicker line and sometimes a sanitary towel in your knickers against the wound can help you feel more comfortable.

Type of stitches depend on the surgeons preference. I had one long stitch with a bead at each end, removed at home on day 5 by the midwife. Again, this just feels weird.

Careful coughing and sneezing. They physio will show you how to brace yourself so you don't strain your incision. Physio will come and see you the day after the op to talk about recovery.

You will be advised to not do any exercise until 6 weeks and then only v gentle stuff. Proper cardio stuff will have to wait until 12 weeks. When you sit up too, use your arms, not your stomach muscles. Roll onto your side and push up on your arms and swing your legs off the bed. It just avoids you straining the muscles too soon.

Lots of fruit afterwards. Bowels will be a bit sluggish at first, so encourage everything to be soft and mobile as much as possible. Don't be afraid to poo though!

Nothing in the bath at first. No bubble bath. Bit of tea tree or salt fine though. Let your wound air dry or v gently pat.

I think I'll shut up now. If I think of anything else, I'll post again.

It's really not frightening at all."

[Writerwannabe83]

I just watched lastnight's OBEM - did anyone see it??

I can't say the failed Spinal block has done much to calm my nerves

Has that ever happened to anyone??

I now have something else to panic about......

That and the fact that my Grandparents keep going on at me about how bad it is that I'm having the CS done on a Friday as 'everybody knows' that the number of Doctors on shift drops dramatically over a weekend and if something were to go wrong with me or the baby I'd be screwed.

How very reassuring....

[CrispyFB]

Ah yes, I forgot about the shaking! Not everybody gets it, but it is annoying. It fades after an hour or so. And I had the itching as the anaesthetic wore off, it was on the "front line" of where feeling was returning. It wasn't nice, but again it passed. It's testament to the fact I've had five spinals and forgot to mention either of these things in my earlier post that shows how insignificant they are in the grand scheme of things. You're meeting your baby! Everything else doesn't matter really so long as it's not too excessive

[Raxacoricofallapatorius]

Home on day two is normal. They will only discharge you if you're up to it, don't worry.

Trapped wind is only a thing the day of and day after the op ime. It's the air trapped from the op and sluggish bowels. They just slow down immediately post op. Happily, a few hours post CS, you'll be merrily farting away with the other CS women. Relax. The discomfort goes when the air does. And yes, they have peppermint water on the ward.

[Writerwannabe83]

Is it quite short lasting then the trapped wind?

My anaesthetist told me that as I'm having the CS on the Friday I should expect to be home by Saturday

[JRmumma]

Ask for it on the post-natal ward, they will have some. You should be ok by the time you go home.

Just be warned you will need to fart but i just didn't care and let them out!

[Writerwannabe83]

Where can I get peppermint water from? It is something most supermarkets sell??

[JRmumma]

Oh yes the trapped wind! The worst part of it all for me. Peppermint water helped loads and so does making sure you get up and move around once you are able.

Also, post c-section my most important piece of advice would be to take your pain killers even if you think you will be ok without them.

[Raxacoricofallapatorius]

Miaow that sounds awful and I'm sorry. You are of course right to bring it up. Your hospital needs to change. Have you given them feedback? I had PTSD after my first emcs and it was caused by some things not being explained adequately, resulting in terror and poor postnatal care. Thankfully, our hospital has fully retrained all staff.

While we are mentioning the unexpected you wish you'd known. I had really uncomfortable shoulder pain post op, like I'd slept funny. It was trapped wind and resolved completely by peppermint water. V sore and v v common and so easily resolved.

[Jcb77]

Yes writer - am an anaesthetist. Although for the purposes of most of the threads I write on I'm just an anxious first time mum!
The painkillers you get put on post section vary somewhat trust to trust (local prescribing policy) but in general are: paracetamol - fine to breast feed with, ibuprofen or voltarol (which is what the suppository you get given at the end of surgery is) - also fine to breast feed - and some kind of opiate. This used to be codeine but there are several drawbacks. Codeine is metabolised to morphine in the body an it's the morphine that actually does the painkilling bit. The degree to which you metabolise it, which is determined genetically, determines how much morphine you get so how well it works as a painkiller. Some people get pretty much no effect, some can be pretty spacey on a fairly small dose. So that's one drawback. With breast feeding, the metabolizes are secreted in breast milk so some mothers end up giving their babies a big dose of morphine which can make them sleepy. There was a case not so long ago (in the states I think) where the baby died from effectively and overdose from opiate in breast milk. There were confounding factors though - from memory the baby had been noted to have been sleepy but nothing much had been done about it, and it's a pretty rare example. So again, we're back to the risk balance thing. For some people, codeine is a great pain killer and fine if you know to keep and eye on your baby and if it seems excessively sleepy then do something about it. For others, it little more than a pants painkiller with constipation side effects.
Oromorph (oral morphine) is usually given for the day or so after the section whilst you're in hospital. Again, can be passed to the baby but again, if it seems sleepy - people around to notice. And it's metabolised much more reliably than codeine. No reports (as far as I'm aware) of neonatal harm.
Naloxone reverses the effect of opioids (including morphine, diamorphine). Diamorphine is heroin, which is why you dh recognised its naloxone response Raxa, but we tend to give tiny doses, esp in a spinal, and not cut it with bleach and inject it with dirty needles!
Most drug manufacturers say avoid in breast feeding, not because they've tested it (ethical nightmare) but because they haven't tested it, don't know and can't afford the litigation if something went wrong. Most drugs used in obstetrics therefore are 'tried by time' i.e. Pregnant women have had them for years without notable consequence. And by the time your baby's born, if it needed a lot of the drugs itself, it'd get them anyway..... Including morphine.

[Raxacoricofallapatorius]

The itch is definitely the diamorphine as opposed to the spinal itself. I had it very, very badly first time round and had it reversed with naloxone. DH was muttering to himself about how quickly it reverses the effects of heroin and had to explain himself after he saw the anaesthetist's funny look. DH is a copper and has seen it used a few times in overdose situations. I refused diamorphine second time round because it's hard to concentrate on bfing your new tiny baby when you want to tear your own face off to get rid of the itch. The drugs used are all bfing compatible btw. Here you are given diamorphine with the spinal and a suppository as they stitch you up. Drugs then become oral and you self-administer.

I didn't shake with my first spinal, but did with my second. It wasn't scary at all. I've seen people shake badly after a natural birth too due to the adrenalin. It soon wore off. It did cause my blood pressure to fluctuate a wee bit too so I had some meds to stabilise it but again, your anaesthetist stays with you until you're all stable and they spot these things happening before you do generally.

I was probably lucky in how quickly my spinal wore off. I had leg movement before I even left theatre and by the time I was back on the ward, I could stand up and move round.

[Writerwannabe83]

Thanks Jcb - do you work in anaesthetics??

The anaesthetist also went through all the pain relief I'd be given.....I assume it's all safe to take if breast feeding?? He didn't mention breast feeding you see and it only occurred to me this morning as to whether there were any issues??

[Jcb77]

Yup - shakes very common but try do wear off. It's odd - some women get nothing, some get them really quite bad. No apparent rhyme or reason and no predicting who will/won't get them. Doesn't even seem to correlate particularly well with whether you have/haven't had them previously (but that's just an observation, not a study!).
The diamorphine in the spinal mix (which gives the best pain relief and is NICE standard) can make you itch. Again, it doesn't happen to everyone and if it does it can range from mildly irritating to absolutely maddening. Piroton can help some but so can naloxone (it reverses the effect of the drug at the receptor site). The disadvantage is that reversing the itch with naloxone also reverses some of the analgesic quality, so as with everything, it's a balance - itch vs pain relief. A little dose might make the itch tolerable without affecting pain relief too much. Either way, shakes and itch do go, they're not a given and some people ony get very mild effects that don't really bother them. Fingers crossed you're in the latter categories.
The time taken for a spinal to wear off varies too. Some people can wriggle their legs a little by the end of surgery, most get some movement back after a few hours. Full walking strength (which is what you're after really) often takes about 12 hours but can take longer (or a patch can take a bit longer still).