Epidural didn't work-- twice

OnWayto3

I'm having a hard time finding info about this online other than women's anecdotal stories...wondering if any of you have had a similar experience and/or if you know why this may have happened.

With both of my previous deliveries, I had an epidural. In both situations, my legs went numb but nothing else. In other words, people needed to hold my spaghetti-like legs because I couldn't, yet all of the labor pains were felt. This time, I've resigned myself to the fact that there will be no epidural. For various reasons, this is okay by me. Nonetheless, I've been curious about why the epidural may not have worked-- twice. Any ideas? I'll bring it up to my doctor out of curiosity, but really, thinking someone on here may know. 

For a little background-- I didn't have it 'too late'  in the labor and I'm not overweight. The second time, the anesthesiologist came in the next day apologizing because she hadn't realized how tall I am (I'm only 5'6") and she figured that was why it didn't take. However, it seems strange to me that both anesthesiologists would mistake my height. Thoughts? Really curious to know if anyone else has experienced this. Thanks!

gaylew5

I've never heard of height having anything to do with  epidurals.  You don't even factor in height when placing one. you go between L4/L5 or  L5/L6 usually, which is just at or below the iliac crests.  Honestly the height thing sounds like some BS that providers sometimes use to lay people rather than admitting that something didn't work.

*also, agree with below. also, you can get partial blocks pure sensory or pure motor, mechanism unknown.  sometimes increasing the dosage of medication overcomes this.

klkonwi

You probably have some type of curve or anatomy issue that the catheter wasn't going into the right place: it is rare for that experience to happen twice! The anatomy issue could be very minor and just cause them to not be hitting the right spot. That really sucks........ to have to do labor without twice! Eek!

devyns2nd

Mine didn't work even on my legs. I jammed my back in my 8th month and they couldn't even get the Cath in right. He tried a test dose and nothing happened. They told me sometimes things just don't line up right and it won't take. I walked to my room after.

I'm still debating on trying again. It's not fun having them dig around and not have the relief after.

iheartpancake

I know this sounds crazy, but are you or anyone in your extended family a redhead? I am strawberry blonde and I tell you what, pain killing medications do not work on me at all. I have essentially had unmedicated teeth filled, wisdom teeth pulled, minor surgery on my big toes and the egg retrieval for ivf. And nothing really touched my kidney stones during this pregnancy. I only recently found out that my sister has the exact same problem. I started doing some fishing around for info and it turns out there may be a connection between the gene that gives red hair and pain medication response. From what I've read it's like a 50-50 belief in the connection amongst medical professionals. I one hundred percent believe it. I never understood why I couldn't go numb and I am terrified the epidural won't work. I've already told my doctor I wanted to be put under if I have a c-section. The redhead gene is recessive so that's why I asked if anyone else in your family may be one even if you're not.

Here is a story of another girl who the epidural didn't work for. I hope this isn't the case for you and you can get some relief this time around!!!

https://allnurses.com/certified-registered-nurse/study-says-redheads-559563.html

OnWayto3

@iheartpancake I'm totally fascinated by what you've written here! I've never heard the connection between red hair/pain medication. As far as my family goes, we have red in our hair-- very distinctly-- but red isn't the first color that comes to mind with anyone in my relatively close genes. Hmm...

@devyns2nd I totally agree that it is NOT fun having them poke around only to be disappointed by the results. That's why I've relinquished myself to going without any pain meds this go 'round. It was worse, I think, to have succumbed to the idea of relief, go through all that anticipation, and then find myself with nothing-- yet stuck in bed connected to machines. Where are you at in thinking about this next delivery?

finchfeeder80

iheartpancake said:

I know this sounds crazy, but are you or anyone in your extended family a redhead? I am strawberry blonde and I tell you what, pain killing medications do not work on me at all. I have essentially had unmedicated teeth filled, wisdom teeth pulled, minor surgery on my big toes and the egg retrieval for ivf. And nothing really touched my kidney stones during this pregnancy. I only recently found out that my sister has the exact same problem. I started doing some fishing around for info and it turns out there may be a connection between the gene that gives red hair and pain medication response. From what I've read it's like a 50-50 belief in the connection amongst medical professionals. I one hundred percent believe it. I never understood why I couldn't go numb and I am terrified the epidural won't work. I've already told my doctor I wanted to be put under if I have a c-section. The redhead gene is recessive so that's why I asked if anyone else in your family may be one even if you're not.

Here is a story of another girl who the epidural didn't work for. I hope this isn't the case for you and you can get some relief this time around!!!

https://allnurses.com/certified-registered-nurse/study-says-redheads-559563.html

Interesting. Just to reinforce the 50-50 thing: Red hair runs in my family. There's currently no outright red heads, but I had red hair when I was small and now mine is brown with auburn highlights, my mom had red hair in her 20's, which is now dirty blond, and my brother has a lot of red in his beard. There's probably more, and I can't think of them off of the top of my head but we're Scottish people, so I'm sure its in our geneology. I've never had a problem with pain relief so far and I've had fillings, my wisdom teeth out, stitches of all kinds. When I had surgery on my leg they put a block on it that lasted for several hours after I woke up, and my foot was definitely numb! 

finchfeeder80

@onwayto3 it might be worth seeing if you can get a consult with an anesthesiologist at your hospital to see if there's anything they can pinpoint as a possible issue. Since I'm fat I had to meet with one to make sure I was a good candidate and he felt my back and my hips as part of the process. It's worth calling a nurse navigator at the hospital or checking with your OB to see if it can be arranged.  

btm013

Well shit, I just thought of something. I have spina bifida occulta of the L5. It's supposedly very common and I have no issues with it whatsoever. I honestly didn't even know I had it until high school and then I forgot about it altogether. Now I'm wondering if I can have an epidural...??? My goal was to go natural with the thought if I need an epidural I will get it. But what if I can't? uh oh....

virginiaunicorn11

Just adding that I am a redhead and have definitely experienced this. I have had doctors accuse me of selling pain meds or overdoing it, because I needed larger doses for pain relief... and I had a doctor yell at me for moving during a surgical procedure, when she somehow didn't believe I wasn't numb (um, then why would I have jumped when your knife touched me?). I am fortunate enough to be pretty healthy so I always forget this issue, actually, until I'm in pain and my doctor thinks I'm a freak!

HayesRN13

This is interesting.. The times I've witnessed them not work, the catheter was not in the right "spot" or had been dislodged. There was also an episode where 2 different patients on same day weren't getting relief, then it was a question if there was no medication in the bags? As in pharmacy possibly made a mistake mixing the bags? We never did figure it out

Maggie0908

It could be that you are more sensitive to pressure as pain than some. Not sure what to do about that medication wise.

HoosOnFirst

btm013 said:

Well shit, I just thought of something. I have spina bifida occulta of the L5. It's supposedly very common and I have no issues with it whatsoever. I honestly didn't even know I had it until high school and then I forgot about it altogether. Now I'm wondering if I can have an epidural...??? My goal was to go natural with the thought if I need an epidural I will get it. But what if I can't? uh oh....

Go get a pre-labor anesthesia consult! That's what I did so they had my background in my file and they could decide early if they'd be willing to do an epi or not. One less thing to figure out at the hospital! I have a nerve disease and apparently the plan is to start me on a light dose of the meds... Hopefully not too low!

MJMum524

This has been an interesting thread. With my first labor, I had an epidural at 5cm. They "topped me up" 5 times over the course of my labor but I kept feeling the pain. I laboured 18 hours. When I was 10cm and had to push, I felt everything and got up to pee right after delivery with no issue. I'm not a fiery red head but have red hair/auburn color. My mom didn't have an epidural with her labors so I can't compare. Now I'm thinking I may have this red head pain relief problem thing too...I've never had surgery other than simple dental fillings prior to labor/delivery with DS. :-S

iheartpancake

Being a ginger can be hard! I am not a full blown red head by any means, but I have first cousins who are so I know I carry the gene. I am three quarters Irish so I know it's in there. I have also been side eyed by every single doctor I tell this problem to. Absolutely none of them believe me until they start working on me. They all make me feel like I'm crazy, but I'm not I swear lol!

I am not sure how different an epidural is when it comes to pain killing since it's a nerve block. I told my midwife and she just told me to tell the anesthesiologist when it's time that previous meds haven't worked. Not super helpful. I agree with previous folks that maybe a consult with someone might help? Then they'd have time to actually sit down and talk to you.

I hope everything works out for you and you have a nice, smooth birth! I wish I had more reliable info on the redhead thing, but when no one believes you, there's no one to talk to to learn lol.

btm013

gaylew5 said:

I've never heard of height having anything to do with  epidurals.  You don't even factor in height when placing one. you go between L4/L5 or  L5/L6 usually, which is just at or below the iliac crests.  Honestly the height thing sounds like some BS that providers sometimes use to lay people rather than admitting that something didn't work.

*also, agree with below. also, you can get partial blocks pure sensory or pure motor, mechanism unknown.  sometimes increasing the dosage of medication overcomes this.

Is it always between the L4-5 or L5-6? I spoke with a friend who is a high risk OB and she said they normally do L2-3 or L3-4. Just curious.

sspyles

I'm a redhead and the semthing happened to me twice!!! My legs were like noodles, but I felt all the labor pains and pushing, and they had to numb me for stitches. I'm not having an epidural this time because being stuck on my back, unable to move to get relief from contractions was a nightmare.

devyns2nd

OnWayto3 said:

@iheartpancake I'm totally fascinated by what you've written here! I've never heard the connection between red hair/pain medication. As far as my family goes, we have red in our hair-- very distinctly-- but red isn't the first color that comes to mind with anyone in my relatively close genes. Hmm...

@devyns2nd I totally agree that it is NOT fun having them poke around only to be disappointed by the results. That's why I've relinquished myself to going without any pain meds this go 'round. It was worse, I think, to have succumbed to the idea of relief, go through all that anticipation, and then find myself with nothing-- yet stuck in bed connected to machines. Where are you at in thinking about this next delivery?

I'm going to try and make it natural. Crossing my fingers that I don't need pitocin. I'm hoping natural contractions are milder because for me pushing wasn't so bad but the contractions were awful. DH is going to try and coach me during contractions. I was terrified when I found out it wouldn't work. I hope I'm more prepared for that reality this time.

And I'm the same way with pain meds and numbing. Wisdom teeth extraction, stitches, and labor. Felt it all. Just a warning to those who are the same that this means the numbing meds did not work when I had 18 stitches post birth. Oh and I'm black headed no red heads in my family.

gaylew5

eek. well the "average" spinal cord terminates at L1-L2.  I don't do epidurals, but i do lumbar punctures (similar concept, except we take spinal fluid out instead of putting in medicine and we go in deeper).  I know our OBs usually do L4-L5.  L2-L3 is very close to were the average spinal cord terminates. they aren't supposed to pierce all the way through with the needle, but this isn't done under image guidance.  i'd personally be uncomfortable with the idea of such a high placement as i really wouldn't want my spinal cord to be punctured.

Taken from "technique section" https://www.womenshealthsection.com/content/obspm/obspm002.php3 Careful attention to patient positioning is critical to successful spinal puncture. Using the iliac crests as a landmark, the L2-L3, L3-L4 and L4-L5 interspaces are identified and the desired interspace is chosen for needle insertion. Interspaces above L2-L3 are avoided to decrease the risk of hitting the spinal cord with the needle. Penetration of the dura mater produces a subtle "pop" that is most easily detected with the pencil-point needles. 

mvargas12

Side question. (STMs+) does the injection for the epidural hurt?

LaurenAnn0405

@mvargas12 they told me it would feel like a bee sting and it did sting but it was a welcomed relief from the contractions!

ETA: apparently I can't spell

Muffinhb

I asked for a numbing shot first. It made it feel more Iike a pinch.

btm013

I spoke with an anesthesiologist today at the hospital where I will be delivering. He said they would go between the L3-4 if need be. He also said odds were they did epidurals on patients who didn't even know they had spina bifida of the L5 and all was well. That last part didn't make me feel better haha but I imagine he's right. I didn't find out I had it until high school and it has never given me any problems.

kimikimi

iheartpancake said:

I know this sounds crazy, but are you or anyone in your extended family a redhead? I am strawberry blonde and I tell you what, pain killing medications do not work on me at all. I have essentially had unmedicated teeth filled, wisdom teeth pulled, minor surgery on my big toes and the egg retrieval for ivf. And nothing really touched my kidney stones during this pregnancy. I only recently found out that my sister has the exact same problem. I started doing some fishing around for info and it turns out there may be a connection between the gene that gives red hair and pain medication response. From what I've read it's like a 50-50 belief in the connection amongst medical professionals. I one hundred percent believe it. I never understood why I couldn't go numb and I am terrified the epidural won't work. I've already told my doctor I wanted to be put under if I have a c-section. The redhead gene is recessive so that's why I asked if anyone else in your family may be one even if you're not.

Here is a story of another girl who the epidural didn't work for. I hope this isn't the case for you and you can get some relief this time around!!!

https://allnurses.com/certified-registered-nurse/study-says-redheads-559563.html

I am a redhead and found out about this phenomenon because I woke up mid-surgery years ago. I don't remember luckily but apparently I went ballistic and injured myself in the process, pulled out all my ivs, etc. What a nightmare. Redheads require more anesthesia than the general population for sure. Luckily when I had another surgery recently my doctors were already aware and said it is researched & proven & part of their practice to up the dose for redheads.

iheartpancake

@kimikimi Oh my god that's terrifying!! I just feel like no one believes me when I tell them. Hopefully I get an anesthesiologist that knows this sort of thing ahead of time

laurendutch

mvargas12 said:

Side question. (STMs+) does the injection for the epidural hurt?

My IV hurt way more than my epidural and I wasn't even in labor (scheduled csection)