Pregnancy

Meeting my consultant

I had my first meeting with the consultant this week. I decided with this pregnancy to get an appointment with a consultant early on to fully explain my medical condition and put together a sort of pregnancy action plan. I have to say that I was a bit nervous about what he was going to say, when I found out I was pregnant and started searching for information a lot of what I found was about whether you had to have a cesarian.

Well I needn’t have worried my consultant is honestly the nicest doctor I have met to date, and lets face it I’ve seen quite a few! He was very patient with me and listened to my medical history before talking about what options are available to me.

Previous Pregnancies

Firstly we discussed my previous pregnancies to understand how I coped with those. I highlighted the fact that I had a really difficult second pregnancy with serious SPD (symphysis pubis dysfunction) as one issue. This was before any of my back problems although in retrospect I probably got the SPD because of my back/pelvis position. I also had contractions every week from week 24 – 37 which was clearly very stressful for me as I was concerned for the health of my baby and if he was coming early. I think at this point the consultant was seriously wondering why I was having baby number 3 regardless of any back conditions!

We talked about my deliveries which were both normal births, the first at 40 weeks and the second at 37 weeks +2. The babies came out fine and were a healthy weight which he said was really positive.

Back Condition

Next we discussed my back condition in detail. I explained what each of the operations were for and how I coped with recovery and the issues I experienced after the first op. See my back story for more info. I asked my physio to write a report about my treatment over the last year so he could understand the ongoing issues I have and also how we are currently managing the pain. This was really useful as the physio was able to highlight all the relevant info for the consultant. I would definitely recommend doing this when you have a consultant appointment.

Medications

Next we talked about medications and any allergies. Well I’m not that great at taking prescription medications in general. The consultant made it clear that there were lots of medications available to try and the only ones that were definitely out of bound were NSAIDs, like ibuprofen and Diclofenac. I can’t take anything with codeine in really, Tramadol made me almost pass out and start talking gibberish. Oxycontin was hilarious, I had this in intensive care and started hallucinating that my husband had just bought a puppy and bought it to the hospital, I was apologising to all the nurses. So we decided that it was best to stay clear of any of those type of medications. The only strong painkiller I really don’t have many side effects to is Morphaine, I was once on 100mg a day and functioned fine so we agreed that this would be our option for pain relief.

Currently I am only taking paracetamol as and when I need it, and then only when I really need to. I had it in my head that if I took it for the slightest ache that over time it would become less effective as my body would be used to it. The consultant explained that paracetamol is different to other pain medications as this doesn’t happen and it’s fine to take it when I need to, it also doesn’t cross the placenta to the baby which is much more comforting to know.

Before I start taking any stronger medications I will think long and hard about it. The decision will be based on what effects it will have on the baby as well as on my health long term. Whilst I had to previously take large amounts of Morphaine to get out of bed, when it came to stopping this it a slow and difficult process.  I managed to wean myself from 100mg a day to nothing in about 12 weeks but felt like I had flu for most of the last month of that as my body was going through withdrawal. I need to consider what this will be like with a newborn against the pain I am in at the time, it won’t be a decision I take lightly.

Labour

Lastly we discussed what the labour might be like. I was pleased to hear the consultant say that he wouldn’t recommend a cesarian straight off. The fact that I’ve had two ‘normal’ deliveries before was promising, your body has a memory for these things and there’s no reason why this wouldn’t be possible again. This would be my preferred option as the recovery time afterwards is minimal, in theory I could walk out of hospital the same day.

Of course depending on what happens during the pregnancy with my back and the baby then he may recommend a cesarian further on down the line. I’m happy to go with whatever is best for the baby and I, I will be guided by the experts and follow their advice. If I could help it then I’d prefer not to have a cesarian, it is major surgery and my concern from a back perspective is that I rely on my stomach muscles to help support my back. Therefore cutting through these for delivery could mean I’m putting my back at a greater risk to injury postnatally, especially as I have a baby and all the paraphernalia to carry.

I’m not saying there is a right or wrong way to deliver this baby just that I have concerns either way.

My other concern is around pain relief, after my experiences I really don’t want an epidural or spinal block, basically no needles near my spine! This is for very valid reasons of past problems see my back story. We discussed other options like a PCA pump and the consultant referred me to an anaesthetist. The anaesthetist will be able to look at my past X-rays to advise whether an epidural would even be possible and what other types of pain relief they could offer me if I did get into a situation where I needed an assisted delivery.

I’m feeling really happy after this first meeting, there’s not much to do at the moment but I am reassured that the consultant will be there when I need him later on in the pregnancy. This has given me peace of mind and I’m quite relaxed about the whole thing. I don’t know what is going to happen as this bump starts really growing and neither do the medical professionals, however if I can make the appointments now and get an action plan in place then if things do start becoming complicated I can get help quickly.

Bluesky thinking – the pregnancy continues without a hitch I become one of those glowing pregnant women that look and feel amazing. I go into natural labour and push the baby out without complication in a reasonable time and can leave hospital that day.

I think I can safely say this won’t happen but hey I can hope!

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