STMs - When did you meet with anesthesiologist?

kwilliams3402 · March 2016

For experienced moms, when did your OB have you meet with the anesthesiologist to discuss labor plans?

I have a chiari malformation (my brain is too big for my skull), so I'm concerned about the added pressure of labor/the effects of anesthesia turning frequent headaches into a much bigger problem. My OB has sent me to my neurologist who wrote a wishy-washy letter and send me to the opthamologist (in 2012 enlarged optic nerves sent us down a rabbit trail that diagnosed chiari), and then the OB sent me to the high-risk doctor to do the 20 week anatomy scan. Today the high risk doctor said she was just asked to do the scan and not the consult (baby looks big and healthy, yay), so the OB will be the one to talk to about labor, but I'd probably need to talk to the anesthesiologists. So, while I see every -ologist in town, no one seems to want to tell me what the best plan is. There aren't any other indicators that I'm high risk or that I need extra monitoring, but I'd like a straight answer on what the labor plan will be (of course, if baby cooperates)!

tisunge602 · March 2016

I'm low-risk, so probably not the best one to answer, but I never met the anesthesiologist until I asked for my epidural while in labor. I don't think it's a common thing to get to meet with one in advance.

ginger819 · March 2016

Same here. I was low risk and didn't meet her until she came in to give me the epidural. Then I only saw her while she placed it and then she was gone, so maybe 10 minutes. Honestly, I didn't go over my birth plan with anyone until a nurse asked if I'd like an epidural or help with breathing and pain management when I came into the hospital, but again I didn't have anything out of the norm to deal with.

bearsandbeets7 · March 2016

There is actually a high risk board under the pregnancy tab where you may get more information. I was low risk and didn't meet him until he gave me the epidural and then again when they took me back for the c section.

Stephanie7693 · March 2016

Yep, met mine 5 minutes before my epidural. You never know who you'll get... it's just whoever is on call

texasmama2014 · March 2016

Will you be inducing it scheduling a csection? If yes, you might be able to get your specific anesthesiologist beforehand, but I'm not sure how it works for high risk...

Neesey · March 2016

I'm high risk but for other factors. I didn't meet with an anesthesiologist until I was getting prepped for the epidural. There are so many on rotation at our hospital that the chances were very low I would have gotten anyone I actually spoke with unless I was having a scheduled c-section.

kwilliams3402 · March 2016

@texasmama2014 - I'm still trying to get the OB to nail down whether a vaginal birth is safe due to pressure or if the scheduled C-section is the more advisable route with the chiari.

1faceinacrowd · March 2016

It sounds kind of frustrating that you can't seem to get a straight answer or figure out what the best plan will be for you; I'm sorry you're going through that. I did a med-free birth but like other mamas here, my understanding is that you don't normally meet with the anesthesiologist at all prior to birth.
Have you considered bypassing the epidural altogether if there are concerns? I don't know anything about your condition but I wonder if it impacts your chances of developing a post-dural puncture headache? Might be something to ask about. My mom, who was low-risk, had a post-dural puncture headache and I understand it's a lot like a severe migraine that lasts for several days. I believe about 0.5-1% of women develop it so it isn't SUPER common, but still something to check into with regard to your medical condition.
There are other forms of pain management for labor that can be administered through your IV, or you could go au natural (med-free) to avoid any potential side effects. Just some ideas... Hopefully you can get your birth plan figured out with the help of your OB and other medical pros.

kwilliams3402 · March 2016

The concern, from Dr. Google and my wishy-washy neurologist, is that the pressure of labor could cause my brain to drop further into my spinal canal, which at its extreme, causes paralysis, but at the least, god-awful frequent headaches that I already get. But, the anesthesia itself, because it's inserted along the spinal canal, comes with its own risks if screwed up. All of that leads me to believe that a plan is much preferred to winging it when I show up at the hospital in labor.

I probably just need to hold my horses and let the doctor figure it out, and get concerned if we're in July and still don't have a plan. My Type-A personality over here is getting antsy!

haboobjob · March 2016

I met with mine a couple hours before my c-section (was originally scheduled a week later but water broke and went into labor - baby was breech). We discussed briefly what was going to happen. I talked to her about my sensitivity to medication and issues with anxiety/panic attacks. She was able to suggest some additional medication to help with anxiety (which I ultimately decided against before the procedure).

Idk if it's a possibility but would see if you could contact the hospital and discuss options with someone on their anesthetics team directly.

1faceinacrowd · March 2016

kwilliams3402 said:

The concern, from Dr. Google and my wishy-washy neurologist, is that the pressure of labor could cause my brain to drop further into my spinal canal, which at its extreme, causes paralysis, but at the least, god-awful frequent headaches that I already get. But, the anesthesia itself, because it's inserted along the spinal canal, comes with its own risks if screwed up. All of that leads me to believe that a plan is much preferred to winging it when I show up at the hospital in labor.
I probably just need to hold my horses and let the doctor figure it out, and get concerned if we're in July and still don't have a plan. My Type-A personality over here is getting antsy!

I know what you mean; I'm very Type A as well (I handed my completed birth plan to my Midwife at our first appointment - at 7 weeks!). Definitely look into other forms of pain management. I can't remember what it's called but they have a pain medication that is administered through your IV during labor. It doesn't completely numb you the way the epidural does (granted, the epidural doesn't always work either) but my understanding is that it takes the edge off and helps you rest between contractions.

Curls919 · March 2016

Mine showed up a few minutes after I requested my epi. It was a short, quick love affair

karaszoo1 · March 2016

@1faceinacrowd Nubain. The juice of God's . apparently makes u say some funny shit too my husband said he could write a book about what I was saying cracking everyone up. 14 hours of labor later and I have no idea what he's talking about.... I even went so far as to whisper (read that as, say very loudly ) to the nurse if the anesthesiologist knew what he was doing when he was placing my epidural...

charmedlifex3 · March 2016

My new doctor said early in my third trimester, we would plan on meeting with the anesthesiologist to discuss options.

I have a rare disease as well, which stress triggers (Trigeminal Neuralgia) so they wanted to make sure they had time to consult with my neurologist, knew what other medications I may be on, and what to watch for. Blood pressure increases can trigger pain which is commonly accepted as being worse than labor, fun fun.

I will say this, my first OB wasn't being responsive to my request we form a plan to deal with an attack during labor (only told me not to worry about it she was sure it wouldn't happen) - I changed OB's at 20 weeks. There were other factors, but that was a biggie.

texasmama2014 · March 2016

Perhaps there is a list of anesthesiologists on staff or a department head you could talk to about specifics so your chart is ready to go and meets your needs?

ashleym373 · March 2016

Probably not helpful but, With DS1 I met them as I was pushing, with DS2 as he was halfway out. I had to sign off both times I didn't want the epidural.

In your case maybe you can have your OB set up an appt to discuss with one? I know at my hospital, big city hospital, there are many possible anthesthologist. So meeting the one for your labor and delivery would be impossible to predict.

rubredvelvet · March 2016

I've had a low risk, and a high risk pregnancy. Both times I didn't meet with them until they came into the room to do it. It really depends on whose on call that day. However, for your particular circumstance I could see why you would want to meet with them directly. If your having issues with your other doctors being wishy washy I'd go straight to the hospital sometime before delivery to ask about it. Even if it's not the doctor who will give you the epi they should be at least able to answer some questions.

Bookhousegirl · March 2016

My experience was like most others in that I met him when he gave me the epidural. The problem is that if you're not having a scheduled c-section it will most likely be whomever is on call when you go into labor. Maybe you can speak with one of the anestheisologists on staff so that you can get some information about how they might handle your situation - even if they are not the one who will necessarily be there when you give birth.

SkiChic626 · March 2016

I met mine when I asked for the epidural. You don't know who it'll be because it's whoever is on call at the time.

charmedlifex3 · March 2016

@bookhousegirl
Yes that's exactly what my doctor is having me do. I'll meet with one of the head doctors from the group my OBGYN group works with, and we'll put together a "If this, then this" type of plan so everyone has some guidance.
Not quite the same as @kwilliams3402 - There is no real physical consequences of the pain my disease causes (other than spiking blood pressure) but the degree of pain has rendered me completely insensible before, one of the reasons my new doctor feels more comfortable with a written plan for pain management in place IF this should trigger, and then they can just get the go ahead from my husband... (and hopefully get me participating in the birth again, to avoid a C-section)

kwilliams3402 · March 2016

Allisun85, I'm glad to hear that I'm not the only one pushing to have a pain management plan ahead of time. If I have 9 months and know that my situation isn't the ordinary one, it just seems illogical to me to not at least know the preferred route to deliver this baby!

KUGirl09 · March 2016

Depending on your hospital, you likely won't have the option to choose your anesthesiologist, as they are on call or not on a daily basis. I was a high risk pregnancy with a history of severe migraines and they didn't give me an option to talk to the anesthesiologist beforehand. My mom has a chiori malformation also, so I feel your pain and frustration. I think having a discussion with your doctor about your concerns and putting together a strong birth plan that discloses this information and having them put it in your chart weeks before your due date is a good plan. From what I was told with my migraines, there is a 50/50 shot either way for residual issues due to labor. The Epidural can trigger worse ones, and the pressure from pushing can too. I ended up choosing an epi, and will do it with this one too. I didn't end up with residual effects, but that is just me obviously.

Jenniferk08 · March 2016

Same as the others. I met mine minutes before needles were put into my back. But honestly at that point I didn't care who the hell walked through the door as long as I had some pain relief. I was getting contractions AND back pain. By hour 30 I told them get me a f@@king c/s now but the nurse talked me down until he got there.
Then all was well, I had a button.

kwilliams3402 · March 2016

Thanks, @KUGirl09--helpful to hear your experience!

ShanRum3 · April 2016

I'm in the same boat as almost everyone else. I never met the Anesthesiologist until he entered my room to give me the Epi. And like @Jenniferk08 said, by that point I couldn't have cared less who he was, I just wanted rid of the excruciating pain that I was having in my back, as well as from the contractions!

mckcak23 · April 2016

Lurking from July*

@kwilliams3402 I am due July 1 and I have a C. Malformation as well. From my talks with others and Internet research the medical community is very split on what the best way to handle labor is. The most conservative say that a schedule c section under general is the best option due to avoiding an epidural and pushing another school of thought is it is such an under diagnosed malformation that a good majority of
people do not know they have it. I went to a neuro this week who looked at me like I was crazy, said he had no concerns about me going through labor. That happened to be the answer I wanted so I'm taking it. In your situation if you are unhappy about the original neuros reponse I would get a second opinion. Most ob's will have no clue what to do with the malformation as it is not their speciality.

If you lurk on the July board there is a thread for mommas with medical conditions (I can't remember the exact title right now) and another user has one as well and gave me a lot of information.

Feel free red to reach out or pm if you have any questions/ need support.

smilormarie · April 2016

An hour before the operation.

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