I've heard a few times now that giving birth while lying on the back is a relatively modern invention and that for most of history women adopted squatting or leaning forward positions.[1] And that the back position is actually much more painful. How much does laying on the back increase the pain to the point where an epidural is necessary? Is it still necessary in the other positions?
Male scheduled for my 3rd epidural with steroids next week for on-going spinal stenosis, relieves pain for a few days, then back to pain.
Will go for minimally invasive micro laminectomy next, tired of treating symptoms and not the root cause.
In that procedure surgeon will remove parts of lower vertebrae that is pinching the nerve bundle, nerves that progress down each leg.
Success rates of better than 70%, it's a gamble. But willing to accept that rather than end up on addictive pain pills for life.
3 to 6 months recovery period before active lifestyle again, cannot risk disturbing the "fix". Giving up flip turns in lap swimming for quite a while. Supplemental covers the other 20% that medicare won't pay.
Cash paying patients suffer $35k to $45 K for the procedure.
Medicare pony's up only about $6,500, which the surgeon must accept, no extra cash changes hands.
Supplemental covers the 20% that medicare will not pay.
Go for surgery if you have neurological symptoms (loss of sensation, motor function, etc). If its pain, try your best to avoid surgery and find the right physiotherapist to help you be pain free. Spine surgery is risky and there is a risk of cascading failures.
Don't completely trust any anesthesiologist (pain management) or neurosurgeon (for surgery) or chiropractor or random folks advice to do yoga/stretch. Spend quite a bit of time understanding the anatomy, read up on everything and maybe you will find the right set of exercises to help relieve pain. Troubleshooting disk/spine/nerve issues is very hard and most doctors don't have any time to investigate it deeply. They just look at MRI. There are lots of people with the same problems showing up on MRI, but they are pain free.
I understand everyone has different beliefs, and personally, I fall extremely short of what I should be, but I just took some time to pray for you and your procedure. I really hope the root cause is fully resolved.
This kind of comment is only marginally better than "well, I asked ChatGPT and...."
You acknowledge the parent commenter knows more than you, but you decide it's somehow helpful to post contradictory information anyway sourced from someone else who also likely knows more than you.
You don't have to listen to Steve Kerr. Every back doctor I have seen has said the same thing - surgery is the absolute last resort. I was fortunate that the epidurals worked for me, because it was the worst pain I have ever felt.
Honestly surgeons should be paid hourly like technicians. $800/hr or something like that. For a 2 hour procedure, $1600. Another $5k for facility and support staff. Looks like medicare is on point...
I'm with you until I remember how expensive medical school plus internship is in the US. If doctors cannot pay back their student loans, it doesn't matter. The majority of folks in medical school have family that can support them now - not fixing education will make this even worse.
Don't get me wrong. I support state-sponsored health care, especially after moving from the US to Norway over a decade ago. Just the peace of mind not having to worry so much about financial ruin because of health issues relieves so much stress - even stress related to just keeping yourself healthy is less (If I get hurt while jogging, it isn't a big issue, for example) But fixing the US system is bigger than just payments or insurance for all. Gotta fix things like education costs, the burden of unpaid internships, and things like that, too. I wish it weren't such a complicated problem and I wish there were the political desire to do such a thing.
This gets said a lot and it kind of irks me. (I am a physician.)
US software devs also make 2x what their European colleagues do, but that never gets called out as bloat. Plus US software devs don't take additional loans for medical school at the rste of $75k per year and then years of low pay residency where their salaey doesn’t give them the means to pay off those loans.
And the best of the best of medical students the world over compete to enter the US market. Being US board certified garners the highest pay even outside the US (eg GCC).
It’s kind of like our industry - the higher comp is a big reason behind how the US attracts talent from all over the world.
Here in Argentina the nurses discourage you to seek it, then they blame the anesthesiologist is not available. We have had 2 with cesarian and one friend was in so much pain that she had to ask for a cesarian too.
It was surprising to see incidence of death by cesarean is almost 13 per 100k. It is commonly thought as the safest way and half of all births in my country are via cesarean.
I wonder how much of that is selection bias? In my (admittedly limited) experiences around the labor and delivery process, c-sections were (apart from when requested) advised for high-risk pregnancies and as a recourse for something having gone wrong in the L/D process. One could reasonably expect that both of those situations would indicate a higher risk for mortality from surgery.
Note that per Wikipedia [0], death by abdominal surgery in general in High-HDI countries is on the order of 100-1000/100k.
In what country do you live? I've had children in two European countries, in both it was common knowledge that natural birth is safer then cesarean and doctors/hospital strongly prefer it.
Seems to depend a lot on the hospital. We (partner is pregnant with a high risk pregnancy) were at a level 1 prenatal care center in Germany a few weeks ago where they very much insisted that in her and the child's condition, a c-section is pretty much her only option.
We're now in a different, also level 1, prenatal care center, also in Germany (though a different state), where the prevailing medical opinion is "natural birth should work perfectly fine for you. We're not ruling out a c-section in case things go sideways, but natural birth is very much our preferred option in your case."
The first center seems to be quite keen on using as many cases as possible for training their staff in c-sections, even where it's not strictly necessary/beneficial. At least that's what we've heard from other parents in similar situations.
I think this is going to depend strongly on population. Average age of the mother, width of the pelvic canal, and similar are going to vary widely with culture, race and country.
I've heard a few times now that giving birth while lying on the back is a relatively modern invention and that for most of history women adopted squatting or leaning forward positions.[1] And that the back position is actually much more painful. How much does laying on the back increase the pain to the point where an epidural is necessary? Is it still necessary in the other positions?
disclaimer: I know nothing about this
[1] https://www.bbc.com/future/article/20260401-women-were-never...
Male scheduled for my 3rd epidural with steroids next week for on-going spinal stenosis, relieves pain for a few days, then back to pain.
Will go for minimally invasive micro laminectomy next, tired of treating symptoms and not the root cause.
In that procedure surgeon will remove parts of lower vertebrae that is pinching the nerve bundle, nerves that progress down each leg.
Success rates of better than 70%, it's a gamble. But willing to accept that rather than end up on addictive pain pills for life.
3 to 6 months recovery period before active lifestyle again, cannot risk disturbing the "fix". Giving up flip turns in lap swimming for quite a while. Supplemental covers the other 20% that medicare won't pay.
Cash paying patients suffer $35k to $45 K for the procedure.
Medicare pony's up only about $6,500, which the surgeon must accept, no extra cash changes hands.
Supplemental covers the 20% that medicare will not pay.
Go for surgery if you have neurological symptoms (loss of sensation, motor function, etc). If its pain, try your best to avoid surgery and find the right physiotherapist to help you be pain free. Spine surgery is risky and there is a risk of cascading failures.
Don't completely trust any anesthesiologist (pain management) or neurosurgeon (for surgery) or chiropractor or random folks advice to do yoga/stretch. Spend quite a bit of time understanding the anatomy, read up on everything and maybe you will find the right set of exercises to help relieve pain. Troubleshooting disk/spine/nerve issues is very hard and most doctors don't have any time to investigate it deeply. They just look at MRI. There are lots of people with the same problems showing up on MRI, but they are pain free.
I understand everyone has different beliefs, and personally, I fall extremely short of what I should be, but I just took some time to pray for you and your procedure. I really hope the root cause is fully resolved.
(While it's clear you've done a ton of your own research for your own case.)
Steve Kerr's advice after his own back surgery complications (albeit microdiscectomy, not a laminectomy) make me hesitant:
"If you're listening out there, if you have a back problem, stay away from surgery... Rehab, rehab, rehab. Don't let anybody get in there."
This kind of comment is only marginally better than "well, I asked ChatGPT and...."
You acknowledge the parent commenter knows more than you, but you decide it's somehow helpful to post contradictory information anyway sourced from someone else who also likely knows more than you.
You don't have to listen to Steve Kerr. Every back doctor I have seen has said the same thing - surgery is the absolute last resort. I was fortunate that the epidurals worked for me, because it was the worst pain I have ever felt.
My mother had this surgery and advised me to never have it done due to complications
Honestly surgeons should be paid hourly like technicians. $800/hr or something like that. For a 2 hour procedure, $1600. Another $5k for facility and support staff. Looks like medicare is on point...
I'm with you until I remember how expensive medical school plus internship is in the US. If doctors cannot pay back their student loans, it doesn't matter. The majority of folks in medical school have family that can support them now - not fixing education will make this even worse.
Don't get me wrong. I support state-sponsored health care, especially after moving from the US to Norway over a decade ago. Just the peace of mind not having to worry so much about financial ruin because of health issues relieves so much stress - even stress related to just keeping yourself healthy is less (If I get hurt while jogging, it isn't a big issue, for example) But fixing the US system is bigger than just payments or insurance for all. Gotta fix things like education costs, the burden of unpaid internships, and things like that, too. I wish it weren't such a complicated problem and I wish there were the political desire to do such a thing.
Medical professionals in the US make multiples of what the same professionals make in Europe.
This gets said a lot and it kind of irks me. (I am a physician.)
US software devs also make 2x what their European colleagues do, but that never gets called out as bloat. Plus US software devs don't take additional loans for medical school at the rste of $75k per year and then years of low pay residency where their salaey doesn’t give them the means to pay off those loans.
And the best of the best of medical students the world over compete to enter the US market. Being US board certified garners the highest pay even outside the US (eg GCC).
It’s kind of like our industry - the higher comp is a big reason behind how the US attracts talent from all over the world.
Medicare for all fixes a lot of the problems with the US health system!
Here in Argentina the nurses discourage you to seek it, then they blame the anesthesiologist is not available. We have had 2 with cesarian and one friend was in so much pain that she had to ask for a cesarian too.
It was surprising to see incidence of death by cesarean is almost 13 per 100k. It is commonly thought as the safest way and half of all births in my country are via cesarean.
There's selection bias. High risk deliveries tend to start at or convert to cesarian at the first sign of trouble.
I wonder how much of that is selection bias? In my (admittedly limited) experiences around the labor and delivery process, c-sections were (apart from when requested) advised for high-risk pregnancies and as a recourse for something having gone wrong in the L/D process. One could reasonably expect that both of those situations would indicate a higher risk for mortality from surgery.
Note that per Wikipedia [0], death by abdominal surgery in general in High-HDI countries is on the order of 100-1000/100k.
[0] https://en.wikipedia.org/wiki/Perioperative_mortality
In what country do you live? I've had children in two European countries, in both it was common knowledge that natural birth is safer then cesarean and doctors/hospital strongly prefer it.
> doctors/hospital strongly prefer it.
Seems to depend a lot on the hospital. We (partner is pregnant with a high risk pregnancy) were at a level 1 prenatal care center in Germany a few weeks ago where they very much insisted that in her and the child's condition, a c-section is pretty much her only option.
We're now in a different, also level 1, prenatal care center, also in Germany (though a different state), where the prevailing medical opinion is "natural birth should work perfectly fine for you. We're not ruling out a c-section in case things go sideways, but natural birth is very much our preferred option in your case."
The first center seems to be quite keen on using as many cases as possible for training their staff in c-sections, even where it's not strictly necessary/beneficial. At least that's what we've heard from other parents in similar situations.
I think this is going to depend strongly on population. Average age of the mother, width of the pelvic canal, and similar are going to vary widely with culture, race and country.
I've woken up from surgery with an epidural that had a leak. That wasn't fun.
It made it emotionally difficult to get surgery again.