What a cute couple! Jill and Scott were in labor. Yep, they were totally in it together. You know, they were the kind who say “we’re pregnant.” They were so excited to welcome a second baby to their family.
It always makes me happy to see a team like Scott and Jill. Watching couples who are kind and respectful to each other is refreshing. I certainly do not take this for granted. Many fathers-to-be seem closer to the TV remote than to their wives. I was anticipating a fulfilling day at the office, caring for these two.
With each contraction, Scott looked into Jill’s eyes and helped her breathe. They had gone through Lamaze classes prior to the arrival of their first baby. “It helps a lot for early labor, but I’m no hero. Sign me up, I’m gonna want my epidural!” she said with a chuckle.
Within the hour, the joking and playfulness turned into concentration. The contractions were clearly getting harder. I gently pressed upon Jill’s abdomen, the contractions palpated strong. I knew it wouldn’t be before I would be calling the anesthesiologist.
When I admit my patients to labor and delivery, discussing pain management is a high priority. Breathing through the contractions, getting IV pain medication, or having an epidural are the three main options for dealing with the pain of labor. Some nurses strongly encourage their patients to get epidurals. They hate to see women in pain. I actually don’t have a preference. I truly believe pain management is a woman’s choice and that she should do what she feels is best for her. Supporting a woman’s decision is my job. Continuously questioning her or asking her if she has changed her mind only undermines her confidence.
Sure enough, before long Jill was ready for me to make the call. She was tired and ready for a break from the pain.
I walked out to the nurse’s station and paged the anesthesiologist. Within 15 minutes, I heard a cart rolling down the hall and a knock on the door. Dr Smith had arrived to place the epidural. Before he could start, he needed to take time to discuss the risks and benefits of the procedure. After Jill signed the epidural consent, Scott and I helped her dangle her legs over edge of bed and moved the tray table in place for her to lean on. Dr. Smith chatted with them as he readied his supplies. “Your position is really important in helping me place this catheter,” Dr. Smith instructed Jill. “I need you to drop your shoulders and place your chin to your chest. Good! Now push your lower back towards my fingers here, arching it just like a Halloween cat. Perfect.”
Dr. Smith’s attending physician, Dr. Wong, had arrived prior to the beginning of the procedure. By the time they begin their OB rotations, the anesthesia residents are skilled at epidural. However, supervision by an attending physician is required.
Dr. Smith’s skill was impressive, and within a few minutes the epidural catheter was in place. Scott held the over-bed table as Jill remained perfectly still, despite the strong contractions. Things were going smoothly. Dr. Smith performed a test dose to insure that the catheter was in the epidural space and not in the spinal fluid.
“Any ringing in your ears or metallic taste in your mouth, Jill?” Dr. Smith asked.
“No,” Jill replied.
“Can you move your toes?” Jill wiggled her toes in response.
“Do your feet feel numb?”
“Nope, they feel normal,” said Jill.
Those were the answers Dr. Smith was looking for. He then meticulously secured the epidural catheter to Jill’s back, using Tincture of Benzoin and 2 inch paper tape. Nobody wanted the catheter to pull out--especially Jill!
Scott hugged Jill and kissed her on the forehead. Clearly he was proud of the impressive job she had done, holding still through such incredible pain. I helped her to lay back down, flat on her back, just as Dr. Smith requested.
“Oh yeah, now I feel it. My legs are getting numb. Will my pain stop soon?” Jill asked.
“Not too long now,” Dr. Smith replied.
A few minutes later, Jill reported that she could feel her abdomen getting numb. Dr. Wong assured her that everything was going as expected.
Another minute went by and Jill started to become restless.
“My breast are getting really numb,” Jill said with anxiety in her voice, “and my hands are getting tingly too.”
The two doctors exchanged concerned looks. Scott was sitting tensely in the recliner by Jill’s side, holding her hand. Dr. Smith began to check the anesthesia level.
“Oh no, something is wrong, I don’t feel well. Oh, it’s getting hard to breathe. Something is wrong. Please, please, do something!”
To be continued…