Wednesday, April 14, 2004

Myths and Facts
Scott writes: Epidurals are risky. There are complications. Granted, the risk is small, but it is real. I know one person who suffered a stroke because of one, and there are worse stories involving paralysis.

I'm not calling Scott out here. He's just repeating what he's been told, and what he may have read. It's time somebody set the record straight though. Have I not mentioned what kind of Dr, Dr Who is?
Oh... my bad... She's an anesthesiologist. This is what she does for a living. Even though I already knew the answers, I asked her about the fears that Scott brings up. She said, "Umm. I have never heard anyone even discuss the possibility of those things." To be fair though she went and looked up the two subjects Scott addressed on Pubmed. Now if you don't know what Pubmed is, it's like Google for medical research. Every case study ever done is there.

What did she find? On Strokes caused by an Epidural she found nothing. No one has ever done a case study on such a thing, so basicly, there is no scientific evidence that it has ever happened. On longterm paralysis related to an epidural, there is 1 case. One. Uno. It happened in 1990. There was sub-dural hemotoma that they failed to diagnose and treat, and that eventually resulted in temporary paralysis.

To be blunt, the circumstances discribed by Scott, do not happen. The main problem here is communication. Doctors suck at communicating, and that's how you end up with these myths. People either don't understand the doctor, or they just think he's lieing, and they formulate their own theories. Epidurals involve the spine, so paralysis must be risk right? No. Not at all.

So, what are the real risks?

1) You can get a wet-tap. A wet tap basicly means they went to deep with the needle and went past the epidural space. That means they puncture the dura, and spinal fluid escapes causing the nastyiest headache you can imagine. That happened to Julie when she got her epidural. It hurts, but it's positional, and it goes away quickly. Caffine fixed her just fine.

2) Longer Labor. Many OB's swear by this, but there isn't any real scientific evidence to back it up. If administered correctly, a woman can get up and walk around while she has an epidural. That is actually the name of it. "The Walking Epidural"

3) No Pain Relief. This is a problem because women don't understand how it works. They go in with unreasonable expectations. The epidural cannot take away the pressure, only the pain. Another big issue is women try to tough it out, and they end up asking for an epidural when it's too late. If you are already in severe pain, and you are worn out and exhausted, the epidural is gonna leave you unimpressed.

4) There is no scientific evidence that epidurals lead to longer labors. The few studies done that make the claim are biased because the patient population they are using is flawed. Its impossible to get a control group.

5) The Drugs get to the Baby. This is just wrong. In fact the very reason they came up with epidurals was to prevent that from happening. The drugs are injected in the epidural space surrounding the spinal column. The drugs never enter the bloodstream, and therefore never reach the baby. Unlike the intravenous analgesia some folks have mentioned.

To sum up, there are thousands upon thousands of epidurals given everyday all over the country. It is one of the safest procedures you can have done. First time mom's should get one, and get them early on. Don't try to tough it out. Many women fall asleep with their epidurals, while they are having nasty contractions. That's kinda the point. You're gonna be sleep deprived for the next 4 weeks. You may as well get some while you can.

No comments: