Anaesthetist Clinic this afternoon - what questions should I ask?

[ifherbumwereabungalow]

Quick history - had a disastrous time having DS, everything seemed to go horribly wrong from the start of the induction. Never dilated beyond 2cms, heart was going crazy, spinal had to be done twice as tube fell out first time, catheter had to be put in 3! times, urine output was terrible (sorry, TMI). Finally made decision to give me an emergency c-section. Pain relief wore off DURING the c-section, when I informed them, terribly politely, that I could feel the pain of the knife cutting I was advised to try the gas and air. I may have sworn.

Anyway, this time around, we have all decided it would be better for me to have an elective c-section. I am seeing the anaesthetist team this afternoon and would like to know if anyone could offer suggestions of good questions to ask them/things I should clarify, based on their own experiences.

Many thanks!

hi - rough ride!!

tell them though, events as you recall them and tell them that is how you recall them. tell them your concerns and because you're a planned section, ask them to go through the spinal/epidural procedure. ask which one (spinal v epidural) they recommend and why. and ask them how they plan to verify if the pain control is adequate, both in advance and during the section, ie what can they do if you tell them you, particularly during, that you are feeling pain.

the birth itself is obviously going to be controlled this time, ie no dilatation issues, and wrt the catheter, that seems to be rotten misfortune, the person putting it in there should be skilled enough that it isn't going to drop out

hth and that you get on alright at your appt and d-day :)

Thanks marbles, I need to get everything straight in my head before I get there, otherwise I tend to get a bit wobbly when I talk about it, or just transform from being a strong minded and intelligent woman to a forelock-tugging Victorian pauper, overwhelmed by the might of the medical professional!

Try writing your questions down and take them in with you. There's no shame in having a prompt for the questions you need to ask.

This time, because it's planned, it should all go a lot smoother. Check that you know the difference between a spinal block, which can't be topped up but does work better if there is scar tissue in the spinal area, and an epidural which can be topped up but doesn't work for all women.

Good luck - planned cs can be very lovely births too. If you do a google you can find ways to make it as lovely for you and baby as possible.

Ah yes world, I am queen of the lists, every time I have an appointment I seem to turn up with reams of paper covered in bulletpoints and far too many question and exclamation marks. I am really hoping that because its planned, it will be a much less stressful experience, and I will definitely be googling later on. Thank you x

I'm sure you already know this, but as it's an anaesthetic clinic, there is probably not much point discussing what went wrong with your labour last time and it would be better to focus instead on what went wrong with the anaesthetic. It would be good to talk through your labour too, but this would be best done with a midwife or obstetrician. From an anaesthetic pov I would be asking the following:

1. Why was the spinal hard to site last time? Was it to do with your anatomy/positioning/skill of anaesthetist? ie. is it likely to happen again and if so what is the plan?

1. Given that the pain relief offered by the spinal last time was inadequate, what is the plan for this time? Are they going to just do a spinal again and hope for the best or will they give you a higher dose of spinal anaesthetic? Alternatively would they consider doing a combined spinal-epidural technique so that they can top-up your epidural during the operation if necessary? Would you prefer just to have a general anaesthetic this time? (They would be unlikely to offer this, as it does have a higher risk of complications, but if you would really prefer it then it may be an option)

1. If you do experience break-through pain during the operation this time, what is the plan and what would you prefer to happen? eg. epidural in place to allow top-up, convert to general, gas and air like last time, intravenous pain relief such as morphine?

Hope this helps a bit, good luck with your appointment.

Thanks daisy, these are some excellent suggestions and I will definitely bring them up. I think I wanted to give them a general idea of what happened as I don't know whether it was the induction drugs that lead to things going so badly wrong, or whether it was further chemical intervention/stress on my body/just one of those things.

Starting to feel a bit tense and nervous about it now...

You'll be fine [hugs] Let us know how it goes.

Thanks Daisy, I have written down your suggestions, alongside those offered by world and marbles, and along with the stuff I already have, I suspect the anaesthetist will be sick to death of me by the end of the appt...

Just wanted to thank the ladies who contributed for their advice and support - the appointment went really well, lovely anaesthetist who is going to investigate what happened so that we can come up with the best treatment for me. Plus, he complimented me on my lovely flat back - strangely flattering for a chubbo such as myself!

Hi OP,

I know you've had your appt already - but just thought I'd let u know you're not alone... V similar story, induced, long labour, emcs but my anaesthetic never worked properly and I also felt them cutting me. Luckily they crashed me under general after a few minutes b/c I was so distressed. Am booked for next c sect in 5 weeks and although v nervous the anaesthetist I saw recently put my mind at ease. Fwiw he said sometimes they don't put enough of the drug in or sometimes don't test it high enough on your body... Best of luck with everything and I hope we both have smooth c-sects this time around :)

This is going to sound really awful, cheaper, but it actually makes me feel better to know that I am not the only person who has been this such an horrific experience... I am so sorry you had such a dreadful time, and I have all my fingers and toes crossed for your Round 2!!

Glad it went well at the clinic, hope it all goes as planned this time (am sure it will!)