# Walking epidural, spinals and more....whats the difference??



## its_our_family (Sep 8, 2002)

I'm vbac but preparing a birth plan and myself for another c/b (ya never know). But I'm confused on painmed options.

What is the difference between a walking epidrual, a regular epidural, and a spinal??


----------



## Eman'smom (Mar 19, 2002)

A walking epidural is a epi, but with less meds, so you aren't totally numb.

A spinal goes into a different space in your back and it pretty quick, and from what I've heard a single dose.

An epi takes a bit of time to take effect, but you can get continuous medicine.


----------



## Greaseball (Feb 1, 2002)

From what I've read (again, only read, not been through!) with an epidural you recover from it much quicker than a spinal, but during the surgery you feel what is going on, the way you do when getting a tooth pulled with only a local anesthetic. You won't feel the pain, but you will feel the sensation of being cut, pulled, fumbled around with, stitched, etc.

With a spinal, you will feel nothing at all below the waist. You'll just be lying there wondering if they are actually doing anything and then you will have the baby. If placed correctly, there won't be a chance of feeling any jostling or pulling. But people also say it's horrible to recover from; you have to lie absolutely flat for 8 hours and can't hold the baby or nurse. It's also possible the anesthesiologist can screw it up; there are stories on this board from people who have had it numb their chest instead of their belly and all sorts of other complications. Some women are frightened by being paralyzed and wonder if they will really recover from it.

But, it could be people have had very different experiences with these meds than what I've read about.

I don't know what I'd choose. I'd almost want to be put to sleep rather than take the chance on pain or a horrible recovery! But that has its own set of problems.


----------



## OnTheFence (Feb 15, 2003)

Just want to say this:

I had a spinal and have done my homework on them. They are quick, one dose medications for surgery. Let me say ONE DOSE. If it starts to wear off during surgery, guess what? You get to feel the pain. I know. I felt the pain for over an hour. I am not the only one with this story, there are many others. Too me, I do not understand why OBs prefer this kind of anest. for csections over the epidural, especially the walking epidural.

My last csection I had the epidural cath put in and I got first dose that took effect in less than five minutes. I could still move my legs and was very comfortable. I did get a cold sensation but after all the damn hot flashes, it was a bit of a relief. :LOL I got another dose right before my doctor cut me. I could still move my feet. I did full pushing and tugging the baby out. There as no pain. Just like deep massage more or less. I got another dose right before leaving the OR. I was still able to move my legs, I even was sitting up in recovery and felt great. The cath stayed in my bag for the next 17 hours. I was given smaller doses by a pump in a timed manner -- I also had a patient controlled pump that I used if I needed to move around or was in pain. I could just give my self a little dose this way. I could have done this every ten minutes but didnt need too. This was considered more of a walking epidural and was patient controlled to some extent. I loved it. I was able to move around, sit up, even get up without any pain. I HIGHLY recommend this type of medication for csections because it gave me effective pain relief and because I didnt have to take drugs that might dim my senses and mind. (that I did have to do after my spinal)


----------



## laura163 (Sep 13, 2002)

I am having a 2nd c-section in 3 weeks and I just assumed I was having another epidural. I asked my OB today and she said she plan on using a spinal. My question, how the heck am i supposed to nurse and bond with my new baby if i have to stay flat on my back for 8 hours?? Is that really true??

laura

Jack 3-22-02
DS #2 12-22-03


----------



## Greaseball (Feb 1, 2002)

She just PLANNED it without you? I wonder if she had ever planned on discussing it with you. It seems like you should be the one who gets to plan these things.


----------



## laura163 (Sep 13, 2002)

I thought that was a little weird too. I mean, for my first birth I planned on getting an epidural and went in requesting one so shouldn't i get to choose for a c-section??? Unless I told her I wanted to go "natural" c-section - as in no pain meds!! LOL


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by laura163_
*I am having a 2nd c-section in 3 weeks and I just assumed I was having another epidural. I asked my OB today and she said she plan on using a spinal. My question, how the heck am i supposed to nurse and bond with my new baby if i have to stay flat on my back for 8 hours?? Is that really true??

laura

Jack 3-22-02
DS #2 12-22-03*
Laura you have a choice. Dont let her tell you anything different. Tell her you want an epidural with a PCAP. (this is a patient control anest pump) that you would keep fpr 12 plus huors after birth. Doctors like to use spinals because they are quick effecting and supposedly provide a better block (not in my case and many others) A spinal will provide you no long term pain relief after delivery. Yes it will be quick acting but it wears off quick too, so hope your csection is the status quo in time frame or else you will feel your guts being stuffed back in and sewn back up. (we are talking maybe 45 minute window) If you do begin to feel pain during the surgery with a spinal, guess what you are chit out of luck girl -- they will dose you up with morphine or demerol until you are on the planet mars and cant remember why you are even there. With an epidural, if you feel pain (not pressure, you will feel them manipulating the baby out and pushing your guts back in but no pain) they can give you more drugs through your epi cath.
Do what is best for you, they can set up an epidural just as easily and can even do it the L&D room before you go to the OR. Your dr doesnt even have to be there. A spinal is normally done in the OR because as soon as it takes, they pull out the knives. With my epidural there was about a 10-15 minute delay until I was actually in the OR. It was really great.

Kim


----------



## Peppermint (Feb 12, 2003)

I am having my 3rd c-section in about 7 weeks, so I wanted to pipe in.

Spinals do NOT require you to lay flat on your back for 8 hours, this is simply not necessary, some Dr.s may actually do that, but I have had the spinal for my first 2 sections, and never felt a thing, and was able to sit up in the recovery room, and nurse right away. There is no reason why you would have to lay flat on your back for any period of time (Although I have heard of that before, so it must be something that used to be the case, but not now).

I was very happy with my spinals in the 2 previous, but I never really looked into the options, which this time I am. Talked to my OB about it today, and she said, to do the research and that it was totally up to me. She did say that if I were obese, or had some other problem that would make the surgery take longer, she would suggest the epidural, but for someone small like myself, with no previous problems with my surgeries, she feels a spinal would be fine again, should I choose that. It is true that after about an hour- 1 1/2 hours, the spinal wears off, so if the surgery takes longer than expected, they will dope you up with morphine or something (although I ended up that way with my first due to horrible shoulder pain after they got my baby out, so it would've happened with an epidural too).

I am also going to have some form of patient controlled pain relief for the first 24-48 hours following the birth, she is leaving that up to me as well, either morphine or darvaset (sp?) on a patient controlled pump, I seem to do better with the darvaset. She says she'll write me to be able to change my mind any time I want, and get whatever I want (she's so good







) I found that for my body morphine does not relieve my pain well, it's really a to each her own thing with pain meds, YK?

Right now I am planning on a spinal - also with my 2 previous sections, the anesthesiologist put a longer acting pain med in the spinal as well (don't have a clue what it was







), so I didn't need anything else for a few hours after the surgery.

Just wanted to drive the point home that spinal does NOT require you to lay on your back after the surgery (better stay on it through the surgery though







), unless of course, your Dr. is stuck in the Ice Age


----------



## OnTheFence (Feb 15, 2003)

Jess mentioned something you should be aware of "Duramorph". It can be injected into your spinal for longer pain relief for after the csection. You may have to ask for this, and it may make you itch. however I have heard good things about it.

I had to lay 24hrs on my back after my spinal, here they ask yout ot lay flay or slightly reclined for 8-12 hrs. This just depends on your dr or hospital. Who knows???

Also, sometimes pain in your back and shoulders can be from gas, if you rock that will help move it. Ask for a rocking chair in your room to sit and rock it out! I read this on Kmom's site years ago and it works!

Kim


----------



## meganmarie (Jan 29, 2005)

Chunky Monkey, you should think about starting another thread, since you'll probably get better answers - this thread is focused on c-section only and choices of types of medication, and it sounds like you are planning for a normal birth assuming all goes well, and have a more general question about the epidural experience.

I am sure there are lots of folks on the main board who will offer you the benefit of their experience.


----------



## SalmonBayDoula (Jul 10, 2005)

Quote:


Originally Posted by *its_our_family* 
What is the difference between a walking epidrual, a regular epidural, and a spinal??

A "walking" epidural is a narcotic only epidural, in my part of the country, Seattle, only one hospital does them and very rarely. Most women who do get them, go on to get the traditional narcotic/anesthetic combo later in labor, as their body habituates to the narcotic only epi and it becomes less effective.

The regular epidural is a combination of narcotic and anesthetic. Using them together allows the doctor to use less of both and still have it be effective, The risk of a spinal headache WITH an epidural is about 1 %. Sometimes the dura (covering of the spinal cord) is punctured accidently during the placement. An epidural directs the medication outside the dura (covering) of the spinal cord. A catheter is left in place for the medication to be continually administered during the course of the labor and birth. if a c/s becomes necessary, a bolus(top off) is given to insure adequate pain relief. It takes about 30+ minutes for the epi to reach full effect during the labor.

A spinal is when medication is placed inside the dura, directly next to the spinal cord. No catheter remains in your back, as in an epidural. You have pretty quick numbing (within 5 minutes or so) and continued numbing for 1-2 hours.

In my area, women do not have to lay flat for any length of time.

Usually spinals are used when women are having a planned c/s or when when are laboring unmedicated and a c/s becomes indicated.

Hope this helps,
Sharon


----------

