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PG & Dr. wants to give a permanent epidural ??

MsHumptyDumptyMMsHumptyDumpty Posts: 1,567
edited 06/11/2012 - 8:38 AM in Pain Management
This is for my adult daughter.

In brief I will explain hers.
l5 - s1 herniated - degenerative disk disease, spinal arthritis, stoniness, scoliosis.

She is 27 yrs old - PG with child #5 - about 7.5 months with due date of Jan 15, 2010

Prier to becoming pg ( which was a opps ) she was "OK" using percocets & Vicodin for her pain. Doses varied day to day based on her pain level. Her average was 5 mg perks 3 to 4 pills daily with 500 mg ( I think that mg is right, they were the lower end mg wise )Vicodins 2 to 3 daily.

It never took her pain away but made her life do able. She was just getting ready to ask for a new MRI as she suspects new damage/injuries to spine as of different and new and higher levels of pain. When she found out she was PG.

She has made it this far through her PG with taking 2 percocets a day as that is all her OB/GYN will give her, as of safety concerns for the unborn baby.

She finally contacted a Pain Management Dr who takes care of PG women ( boy was that hard to find ! ). The PM Dr and the OB Dr are talking back and forth of what to do for her. Right now her OB wants her to stop all drugs and get a permanent epidural. She told my daughter that is what she will agree to when her and the PM Dr. talk ( some time next week ). She informed her that she will not be giving her any more drugs.

We ( as in our family ) know very little about this permanent epidural. However my daughter is in tears about it as - she feels ( and I am not sure myself ) that her epidurals is what may have weakened her spine to start with.

Allow me to explain - she had a epidural with labor in all of her children. The first 2 went like text books. The 3rd one took about 17 :jawdrop: attempts to get in correctly!
The 4th one took about 4 attempts but then she needed 3 blood patches done as of the never ending migraines she was having after the last epidural.

Within 2 months of having her 4th child she was walking across the floor of her home and her back "went". her legs went numb and she lost bowel and bladder control.

At the hospital they wanted to operate on her NOW. However the hospital they wanted her to go to did not have a bed. So she stayed at the original hospital waiting for a bed. mean while being giving mass doses of steroids and pain meds. A few days later the surgeon came back and said that since she regained control of her bowel and bladder and her pain was under control she did not need surgery after all :??

She was sent home and did PT 3 x a week for 2 yrs - never making any progress with her pain or back weakness.

Now ........ this permanent epidural ?

Thoughts, opinions please ?

PS: Also last week she asked me to look at her back. At the top of her but crack her back dints in like 2" to 3" and the top part of the back bone is protruding forward ( about 3" above her but crack ) pressed against the skin. That area is VERY hot to the touch. She says this is where most of her pain is now. Her OB did not even look at it just said to her "well you are PG".

The PM Dr. has never met my daughter. She won't even met her until her OB gives the final OK. All this talk on her end has been over the phone to my daughter and to the OB.

PSS: This PM Dr. was referred to us by a TOP Hospital that treats women for any OB/GYN issues and takes care of the high risk PG women. They said she is the only PM dr around who will take care of pain in PG women.
L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
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1

Comments

  • not 1 opinion :?
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • Howdy MsHumptyDumpty,

    Sorry missed this posting for some reason - my bad! I don't know a lot either about the "permanent" epidural, especially where you posted the "regular" ones didn't help?? The bowel loss issue bothers me a bit. Even if it did go away for a time, who's to say it won't come up again? The deformity that you can feel in her back - wow! I would RUN and get another opinion. She has issues that are way above me, but I don't think I would accept a reply of "her bladder is under control, bye, bye."

    Please get another opinion before a device is inserted and thus (to me) ignoring her more serious issues. Good luck, and sorry you and she are going through this!! *HUG*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • My Thanks ♥ I fully agree with you. However her being PG NO ONE and mean NO ONE will even see her. I have called HUNDREDS of Drs of all different fields and none of them will see her :(

    Even this current PM Dr has NEVER seen her and won't until the OB gives the OK.

    The OB says the only way she will give a OK is if my daughter agrees to a permanent epidural - hence the reason for this post.

    The "regular" epidurals worked for her pain ( while in labor ) but if you read back you can see why she fears another one as of all the horrible experiences she has had with them in the past.

    She plans to not have one for this upcoming labor in Jan as she is so "against" them now.

    To get a new OB is almost impossible right now - we have also tried the route. NO ONE will see her :(

    We have a family friend who is a Dr ( and no even he will not see her - but has recommended other Drs - but they won't see her )and we asked if we should just take her to the ER. He said in his option if she goes to the ER she will have a huge X on her as a PG woman seeking drugs...... sigh

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • I'm afraid I don't have much to offer either, but thought I would respond. I read your post when it first went on the board and I did a little research on the permnanent epidural as I did not know what it was either. Then I felt like your daughter's problems are simply beyond my knowledge, so I didn't respond.

    From what I read, a permanent epidural is a catheter-like system to get drugs to her without them having to go through the blood stream. It is used with people who need ongoing drug therapy such as for cancer. I don't think there is reason to think the procedure would weaken her spine. It isn't like an epidural injection where she would be having a steroid. ("epidural" is just the location where the needle is inserted -- it is not an "epidural steroid injection" like we get to treat various spine problems.)

    As I understand it, your daughter would be getting some liquid pain medication. The delivery system would be the epidural catheter. I'll see if I can find the link I was reading and I'll PM it to you, if I can locate it again!!

    Does that make sense? I don't think it is anything to be feared. It would bypass the fetus and hopefully provide pain relief to your daughter as well.

    Regarding what is causing the pain, that is a different topic! I really don't know how any young mom deals with back problems and babies at the same time. I really can't imagine physically how it is possible. We all do what is required and then we end up paying for it with the health of our spines.

    From what you describe as her issues, I would think your daughter will need to have some more permanent treatments when she can find the time to do it. It sounds like she may have to do something about that herniated disc, if it turns out to be the pain generator.

    I hope this helps a little bit. You might try calling around to see if there is a spinal specialist who would take on your daughter's case and work with the ob. prior to her delivering the baby.

    I'm sorry she is having all these issues. There is never a good time for back pain, but this certainly doesn't make a pregnancy any easier.

    Blessings,
    Gwennie
  • Howdy MsHumptyDumpy,

    My guess as to why they don't want to touch her while she is pregnant (And Gwennie would know this much better than I would) is that they probably couldn't get a good MRI on her depending on how far along she is. I am saying that due to pressures on her back from the baby. Additionally they wouldn't want to give her many if *any* drugs in the interim while PG. Once she has the baby, her back would "go back" to her "normal" state so they can get a "true" feel of what is going on there.

    My other guess? Medical liability. Again, not a medical person here, just going on logical guessing here. I would normally ask why one would get pregnant with such painful back issues going on, but you did say it was an "oops"...:-)

    I would guess based on what I saw of Gwennie's post, the permanent epidermal placement might be more precise, and that would be less painful for your daughter. If that is the only way to control her pain *and* the fetus is not at risk, maybe she should try it. Dunno.. not a Doc or OB here. I hope it works out well for her. Keep us posted what you all decide to do. Take care. *HUG* <---- For you and your daughter!! :-)<br />
    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • You will never fully know how VERY helpful this is !!!!! ♥ I only wish the Dr would have explained this to my daughter. My ( our ) GREATEST Thanks ♥

    I am headed to call her right now to explain what this really is.
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • MsHumptyDumpty said:
    You will never fully know how VERY helpful this is !!!!! ♥ I only wish the Dr would have explained this to my daughter. My ( our ) GREATEST Thanks ♥

    I am headed to call her right now to explain what this really is.
    I am guessing you mean Gwennies post - she is very up on a lot of this stuff. I love that part!!! :-) I will keep checking up MsHumptyDumpty to see how things around going for you and your daughter. Good luck with it!! *BIG HUGS*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Brenda - I did not mean to leave you out - my apologies :)

    I just HAD to rush off and call her ASAP and explain this to her.

    I will have to save it for tomorrow though as I think they have turned in for the night already - drats !

    Yes I agree with you - that so much of this is CYA lol - my words not yours lol ;)

    We ( as a family ) FULLY agree we want what is best for Lucas ( the unborn boy ) - we also think that his mommy being in THIS much pain is not very good for him either.
    She is not seeking drugs per say - just asking what is safe to help her through this. Truthfully right now she just wants to know specifically what this new "event" ( the extreme dipping in tail bone area ) is and if it is something dangerous for her or baby....

    This is child #5 - ( but child #1 since her injury ) so she does know that SOME of this pain will go away after he makes his arrival :)

    My Thanks ♥
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • Hehehe.... No need to apologize at all! As I said, Gwennie is tops in a lot of this stuff!!! I am glad that you are finding some of the answers, or ideas that work for you guys!! I hope she finds relief, and the little one comes into this world as a wonderful daughter, and GRAND daughter!! Glad things are working out MsHumptyDumpty!!! :-)

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • PS: Brenda - Thanks :D

    Unborn baby is a son/grandson and name is Lucas ;)

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
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