Jan 25

“Well, I’ll Try But I Really Doubt This Is Going To Work.”

“Well, I’ll try but I really doubt this is going to work.” – Anesthesiologist while administering an epidural to a laboring mother.

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There are 11 comments to this post.

v had this to say, Jan 25, 2012 @ 7:02 pm (Quote)

Uhhhh…???!!! Reeeeeally need a pink on this one!

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Sarah Reply:
January 25th, 2012 at 7:06 pm Sarah(Quote)

No kidding, because my first thought is that most anesthesiologists swear by epidurals.

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Jespren had this to say, Jan 25, 2012 @ 7:38 pm (Quote)

Waiting for pink link too, but my first impression is mom is not stick skinny, as I’ve heard a lot of anesthesologiest complain about how difficult it is to place an epidural on a ‘fat’ person either because of the extra skin or because they can’t bend forward far enough to properly round their back. Don’t mistake my comment, it’s BUNK, but I’ve heard it a lot.

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Arzt4Empfaenger Reply:
January 28th, 2012 at 5:07 am Arzt4Empfaenger(Quote)

Well, when someone’s morbidly obese, the thickness of the fat layer can actually be a problem since the needle won’t reach far enough. That’s a fact.
Being a bit overweight does not do that, though. Pink link would be interesting – when contractions are not very far apart, the lack of staying still could be a problem for placing the needle. (Or maybe the anaesthesiologist just sucked at his job.) However, he/she could have should have phrased his concern better, or just have said “I’ll give it a try, now”, and nothing more.

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Jespren Reply:
January 28th, 2012 at 5:33 am Jespren(Quote)

Yeah, except in the ‘so obese I can’t walk’ stage I call B.S. my dad is 6’6″ and had a spinal block for pain control (several times) before back surgery for pain relief. At the time he was 350+ and just *barely* fit in an mri machine. But his anastheologist never complained. A doc can easily find a 6″ long needle when they need to do a steroid injection into a hip joint or a 12″ needle when they do an amnio. ‘Too much fat’ for the needle to get through is a lazy excuse. Maybe they’d need to grab an ultrasound machine to help with visualisation if the doc can’t palpate the bones due to overlying tissue (like they do in plenty of other deep tissue procedures), but inability to do one is not the patient’s fault, regardless of how much they weigh. It’s just a lazy excuse from a doc who either can’t or doesn’t want to deal with their inability to help a specific patient.

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Arzt4Empfaenger Reply:
January 28th, 2012 at 5:48 am Arzt4Empfaenger(Quote)

I disagree partly. Very obese people can be difficult sticks, but of course not all have to be. Ultrasound is a good idea, but there are limits to how deep they reach. And not every hospital has the highest resolution/strongest reach u/s available, and not all anaesthesiologists are trained with u/s devices. And without being used to it, the device alone isn’t very helpful.

So naturally it may be laziness sometimes, just as many other things can be attributed to laziness or even maliciousness (see all cases where health care providers just blame the mother on eating to fat/too healthy/growing small or big babies etc.), but it doesn’t have to be. Many times it is just damn difficult, and often impossible. It’s not rare to have lice and flea at the same time, too, so you got bad cards when someone is for example obese, with altered spine structure (i.e. arthritic changes) and unable to bend far enough or at all, and keeps moving around. (Not talking about someone young and unproblematic, who might be flexible like Sammo Hung and can probably bend and flex far enough to let anyone stick him with a long dart needle…)

Anyway, I’m sure mom had a reason to submit this quote, maybe the tone was the problem or the whole setting (or maybe the doc had never done an epi before or just sucked at them? Which would be a whole different fail.)

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Tee had this to say, Jan 25, 2012 @ 7:38 pm (Quote)

Okay, I’m confused. Isn’t that sort of his job?

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Jen had this to say, Jan 25, 2012 @ 7:41 pm (Quote)

That gives me the heebie jeebies. If the mother has a physical or mechanical issue that would make an epidural difficult to place or unable to work, WHY would you put her through the risks with no expected benefit? You’re messing with someone’s spine here. Shouldn’t you first discuss your concerns, as well alternatives?

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Mama Wrench had this to say, Jan 25, 2012 @ 7:46 pm (Quote)

My first epidural, for a “fetal distress” c-section, they got the epidural in on the first try, no problems, in just a few minutes. I never even felt it go in.

Second epidural, in the middle of labor (at 8 cm), anesthesiologist complained that my spine was curved, tried three different spots, and hurt so badly I screamed for him to stop several times and he kept going anyway. (In hindsight, I’m glad he didn’t listen, but at the time I felt like I was being tortured.)

Just being a professional does not automatically make you good at your job.

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