Re: epidural

[Guest guest]

In a message dated 9/2/01 7:04:22 PM Eastern Daylight Time,

duodenalswitch writes:

<< id no.

However, he said if you insist on it, he would not stop it. I jus

had total knee replacement and insisted on an epidural. I will assure

you that you feel a thousand times better post surgically, because

you are not having to wear off a general anesthesia...(which takes

weeks and immediately after surgery can make you nauseas as hell) but

also, you wake up from surgery numb, which you really wanna be! >>

Thats what I thought! But please explain - if you get an epidural, you don't

get general anesthesia? But you aren't AWAKE are you??????????

Carole

[Guest guest]

carol,

You are definitely asleep during the entire procedure. The

difference is the type of sleep. Unfortunately, I can't medically

define how a twilight sleep is different from the general

anesthesia. All I can tell you is that after having 7 surgeries,

these past two with an epidural have been SOOOOOOO much better for

me. The epidurals were totally painless...in fact hurt less than

them attempting to put an iv line in, and I am subject to migraines,

and I had no headaches or grogginess after the surgery.

Theresa

> In a message dated 9/2/01 7:04:22 PM Eastern Daylight Time,

> duodenalswitch@y... writes:

>

> << id no.

> However, he said if you insist on it, he would not stop it. I jus

> had total knee replacement and insisted on an epidural. I will

assure

> you that you feel a thousand times better post surgically, because

> you are not having to wear off a general anesthesia...(which takes

> weeks and immediately after surgery can make you nauseas as hell)

but

> also, you wake up from surgery numb, which you really wanna be! >>

> Thats what I thought! But please explain - if you get an epidural,

you don't

> get general anesthesia? But you aren't AWAKE are you??????????

> Carole

[Guest guest]

> - No, an epidural isn't given as surgery anethestic even with

a

> laparoscopic surgery (general is always used) BUT, an epidural CAN

be used

> as a pain relief measuring following lap surgery. I think Dr.

Welker uses

> them but I don't think other surgeons who perform laparoscopic DS

routinely

> advocate them (although there may very well be others that do).

Ah, misunderstanding. I meant to type that you can't use an epidural

as an anesthetic with laprascopic surgery. You most certainly can use

it for analgesic purposes.

To the person who asked if it is still given in the spine, from your

persepctive, yes it is. It actually goes in the epidural space that

surrounds the spinal column.

This thread started because someone was comparing how much better

their immediate recovery was when given an epidural for anesthesia

and then some sedation rather than general anesthesia. Regardless of

whether you have open or lap DS you will have a general anesthetic

for the surgery itself. Some docs use an epidural for pain relief

(analgesia) afterwards.

Open DS with Dr. Anthone 7/6/01

[Guest guest]

> cynthia: I think any epidural can cause a headache. The reason

for this is

> improper or inaccurate insertion, I believe. Part of the reason

for a

> headache *may* also be due to the mix of drugs in the epidural, but

I'm not

> sure. I think that spinal/epidural headaches ARE rare but they can

happen

> with any epidural. Some are so severe as to require a 'patch'

where fluid

> must be replaced into the spine. I think most anesthesiologists

can know

> when a headache may occur - they get a 'wet tap' or something when

they are

> inserting the needle?

>

> Any professionals out there who can clarify?

If the epidural needle is placed too far in, it will puncture the

membranes surrounding the spinal fluid and you will get a wet tap. In

practioners that do epidurals frequently this is uncommon. Also it is

pretty unusual for spinals to cause headaches anymore because the

size of the needle is so thin that little spinal fluid is lost. The

headache is caused by a loss of spinal fluid which causes the brain

to literally sag. Depending on the severity, simply increasing fluid

intake (oral or IV), may make the headache go away. A patch may be

used which involves taking some of your own blood and injecting it

back into where the spinal or epidural was given.

Hope that helps.

Open DS with Dr. Anthone 7/6/01

[Guest guest]

In a message dated 9/3/01 1:25:42 PM, duodenalswitch writes:

<< That was my fear and Dr Welker said I react to morphine that way becuz my

system cant handle it so thats one reason we went with the epidural.......I

hated the sick feeling with the morphine so I understand where you are

coming from!

>>

Speaking of the epidural, I did ask about this with Dr. Gagner. He said that

he greatly preferred the pain pumps after laparoscopic surgery, thought that

his regimine of combining the pump with regular doses of Torodol (I'm not

sure if the other surgeons in the practice use Torodol from the beginning or

if they use it to increase efficacy of the pump if the drugs in the pump

alone aren't enough - something to definately ask about) was a superior form

of pain control. However, he did mention that I could have an epidural for

post-op pain relief if I preferred.

After doing research and learning they do a 'blind epidural' at Mt. Sinai

(without the aid of floroscopy, which can guide the needle) I decided against

it because anesthesiologists had EXTREME difficulty inserting epidurals for

both of my labors (I know - it isn't in the same place but there's something

about my spine that makes it extremely difficult to insert the needle). They

did say I could insist on floroscopic insertion, but to make this very clear

beforehand b/c they'd have to reserve the floroscopy room, etc. and to arrive

at least two hours beforehand for this.

Dr. Gagner also does a 'deep tissue anesthtization' (not sure about his

associates)

before closing so the tissue is numbed from the inside as well.

An epidural may be a possible option at Mt. Sinai although it isn't a

traditional or preferred one. I would discuss other drug possibilities for

the pump and also the possibility of epidural with your surgeon. Post-op

pain control is an important issue and you should feel totally comfortable

with it.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

seven months post-op and still feelin' fabu!

preop: 307 lbs/bmi 45

now: 224