Post Dural Puncture, Spinal Headache – Intrathecal (Epidural) Complications

hospital waipuna intrathecal

 

**DISCLAIMER: My intention with this post is in NO WAY meant to advocate for or against the hospital, the procedure or any of the doctors at Maui Memorial… just sharing my personal experience. It was such a confusing time and we really felt helpless and didn’t know what to do. I didn’t know this could happen, until it happened to me. As stated below, my labor and delivery were a dream! The complications afterwards, not so much.**

 

 
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UPDATE: 

It’s been 6 months since Waipuna was born and I feel almost 100% back to normal. I go to the chiropractor regularly to stay in alignment and have been working out to make sure my core is strong. I do sometimes feel pain in my lower back so I use a pillow behind the small of my back in the car and bring it with me whenever I need to sit for long periods of time (movies, conferences, etc…). When I get out of bed in the morning I need to really engage my core to get up and have to be careful about the way I get up and down to make sure not to aggravate the injury. My worst fear is that I somehow “pop off” the patch my body created naturally and go back to being in pain. Chronic pain would be terrible so I thank my lucky stars that I feel good and have been really appreciating my health every day.
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Original Blog:
Creating a baby is a true miracle. It blows my mind to think I grew an actual human being in my belly and then gave birth to it. Amazing!

 

With Jackson, I had every intention of doing what my body told me to do… my body screamed “help me!!” about 9 hours in. When I reached active labor I decided I wanted at least the option to get an epidural. I asked for it and was told it would be about an hour before an anesthesiologist would be available. We were at Kapiolani Hospital and went into labor on 10-11-12… lots of people scheduled their c-sections for that day! lol When the anesthesiologist got to my room, I said “do it!” (I’ll blog about this experience – which was a good one! – soon.)

 

Each pregnancy is different and each delivery is different so I again made a decision to see how it goes and listen to my body. I was still considering Kapiolani (on Oahu) but we live on Maui and baby came 9 days early, so off to Maui Memorial we went! My labor progressed very quickly so by the time I got to the hospital (which is 1 minute away from my house) I was already 7 centimeters dilated. I asked for the anesthesiologist and my doctor right away. The anesthesiologist came almost right away. My platelet count was right at the cusp of what is acceptable to get an epidural. She asked if I wanted it and I hesitated. Hind sight is 20/20 – my gut was telling me to proceed without it. All natural this time!

 

My fear took over however. I couldn’t help but wonder… how much more is this going to hurt? What level of pain can I really handle? Will I be strong enough? My fear overwhelmed me and I said “do it!” – the epidural, that is. In fact, I was insisting… “go, go, go, go!”

 

The doctor was at my back with the needle and asked me to hunch over. I did as I was told. All I remember from that period of time is thinking… “What’s taking so long?!” Between contractions I kept insisting “go, go, go, go!” I knew that it wasn’t safe to do it during a contraction when I would most likely move and could jeopardize the operation.

 

The doctor then said “Your vertebrae are very close together. Can you give me more of a C curve?” I remember thinking, “What do you mean? Couldn’t you have told me that from the beginning?” (Not trying to bash anyone, just telling you exactly what I was thinking at the time.)

 

After that, the needle went in and I almost immediately lost all feeling from my hips down. This was new for me. With Jackson and the epidural I still had feeling all the way through my labor and delivery. This time, I felt like I was paralyzed. It was very scary and totally played tricks on my mind! I asked if that was what was supposed to happen and they assured me YES. In fact, I actually had not received an epidural. Because I was so close to being complete (10 cm.) they chose to do an intrathecal instead. From what I understand, this is a smaller needle, the pain relief is more immediate and numbness lasts for about an hour or so before wearing off.

 

To be honest, I was on cloud 9! I said to my OB, “If this is what having a baby is like, I might do this again!” Though the temporary paralysis was totally freaking me out – I had to turn away when they moved my legs around – the fact that I couldn’t feel A THING made the delivery pure joy! Baby popped out like a champagne cork (as my mother described it). I was laughing when she was delivered. No pain. at. all.

 

Baby Waipuna - not even 1 minute old yet

Baby Waipuna – not even 1 minute old yet

 

Another silver lining was the fact that my mother had just flown in (a couple hours prior) and at the last second I decided I wanted her there for the delivery. If I had not gotten the intrathecal she would not have made it in time. The intrathecal allowed me to be in active labor (at 10 centimeters) without feeling the contractions so I was able to wait to deliver my baby girl until she arrived at the hospital.

 

hospital waipuna intrathecal

 

Now the flip side… I had an amazing 12-18 hours postpartum! Baby was healthy and happy and the delivery was truly a dream (will blog about that later) BUT, shortly thereafter I started to feel stiffness in my neck and back. I mentioned this to my night nurse and she went to check my chart. She said that the anesthesiologist had poked me twice before getting the needle in the right spot on the third try. She thought this may have led to a spinal headache – which she described as the worst migraine you’ve ever experienced in your life, it’s debilitating – and she recommended I get the blood patch right away.

 

The first 12 hours or so were a dream!

The first 12 hours or so were a dream!

 

What?!!! Holy cow. I was beside myself… my husband and I started doing research on “spinal headaches” and “blood patches” to see what exactly I might have gotten myself into. That night, the anesthesiologist on-call came to my room to discuss my symptoms. The problem was, my symptoms were not as severe and acute as with those that get a spinal headache. Was it a spinal headache or not?

 

I had some of the symptoms. The stiffness in my neck and back was intense. Tension in those areas had me in tears. When upright, I had a dull headache similar to the beginnings of a migraine. When I would lie down, the headache would go away. I was also nauseous when upright but not when lying down. These were hallmark signs of a spinal headache… BUT, the symptoms weren’t as severe as with most patients… so we weren’t sure. 

 

Here was my dilemma. If they could confirm I had a spinal headache, I would go for the blood patch. (Here’s more info on spinal headaches and the blood patch.) … but no one ever actually said “You have a spinal headache”. From what I understand, a blood patch is when they draw your blood and then reinsert it into the area where you were poked in the first place. This did not sit well with me because I didn’t want to get poked again and possibly have something else happen. If I TRULY had a spinal headache – I would undergo the procedure… but, I didn’t. Or did I? We were in a state of limbo.

 

We waited to see how my symptoms would progress. If they became a full blown spinal headache, I would do the blood patch. If they got better, I would know I was on the road to recovery with my own body filling and “patching” the hole created by the extra pokes.

 

My problem? It never got better. The first three days of my symptoms, they got worse. BUT, not bad enough for me – or the doctors – to confirm I had a spinal headache. Then, my condition plateaued – FOR DAYS. I stayed in the hospital the first three days, in case my condition worsened, so that I could go straight in for my blood patch. I should mention, the nursing staff, my OB and the maternity wing at Maui Memorial were amazing! Everyone took really great care of me and baby during this time of uncertainty. We also saw four different anesthesiologists. I never asked for one, the staff sent them over to me at regular intervals to check on me and discuss my symptoms… they all pretty much told us the same thing. My reaction was rare. They weren’t sure if I had a spinal headache. They could do the blood patch if I wanted it but none of them actually came out and recommended it.

 

We decided to stay in the hospital for a couple of reasons. In case my symptoms got worse, we wanted to be able to immediately take care of it. I was also in enough pain that I needed help taking care of baby. Plus, we went through several different pain management methods. I didn’t want to do anything extreme since I was breastfeeding.

 

hospital waipuna intrathecal

 

On the third day, a male anesthesiologist came to speak with us. He said “You guys are obviously well educated. You did your research on this and I think you’re overthinking it. I would do the same thing, if it were my wife but this isn’t helping you.” I asked him what he would do if it were his wife in my position… he said “go home.”

 

hospital waipuna intrathecal

 

So we did.

 

Trying to enjoy my baby through the pain...

Trying to enjoy my baby through the pain…

 

I went home… in pain. Sitting upright in the wheelchair and then again on the 1 minute ride home was torture. Mind you, my newborn baby girl was along for the ride this entire time. The next few days were spent lying on a futon on the floor (the bed was way too soft and triggered intense involuntary spasms in my back and neck).

 

hospital waipuna intrathecal

 

I only was upright to go to the restroom or eat. I breastfed baby lying on my back. I alternated heating pads on my back for the pain and on my front because I was engorged. Pain in front and in back… it was intense. The best thing I found to reduce the pain and disperse the tension was having my husband massage my back. He would sit by my head and take his hands under my back (while I was lying on my back) and push up against my back and toward my neck. I also used essential oils, electro therapy and ice to try to manage the pain.

 

hospital waipuna intrathecal

 

There was one night when baby was crying and my husband was dealing with that. Then, Jackson (the 3-year-old, who was also very sick) came running in our bedroom while I simultaneously had an intense spasm in my back. Baby and mommy were both crying and all Kaimi could do was take Jackson outside the door to our bedroom and close the door.  Now Jackson was crying on the other side of the door too! It was overwhelming. I can’t imagine what Kaimi was feeling. First, he jumped over to me to help get rid of my spasm, then passed baby to me to breastfeed and went to the door to calm Jackson down. All is well that ends well but that moment definitely stands out.

 

hospital waipuna intrathecal

 

The hardest part of this whole ordeal was not being able to take care of my newborn baby. I tried… once. She was crying so I got up to change her diaper. From bending over her for that one minute, the resulting spasm was so intense it put me in tears. I didn’t change or hold her again until the pain subsided, 7 days after her birth.

 

About a week after delivery was when I started to feel a little better. Slowly but surely I eventually was able to stay upright for longer periods of time. To this day, I still have pain where I was poked. Usually early in the morning when I’m getting up out of bed. I need to make sure my core is engaged and I’m positioned just right so that I don’t aggravate the area.

 

While in the hospital I did take some medication. The meds were supposed to help us confirm whether or not I was having a spinal headache. I got the shot – I can’t remember what it was anymore – but it didn’t really help. I also took ibuprofen – which helped but didn’t make the pain disappear.

 

Mahalo to all of the mommies that gave me advice during this difficult time. I reached out on social media and your stories helped give me information that I couldn’t find on Google. It felt good to know that I wasn’t alone. A big mahalo to my mom and Kaimi for being the most awesome night nurses. They switched off in the hospital because on day 3, when Jackson came to visit, he threw up all over the hospital bed! When it rains, it pours. Kaimi went home with Jackson and my mom was able to stay with me in the hospital and help with baby and managing my pain.

 

hospital waipuna intrathecal

 

I’m not sure what I would recommend to other mamas out there. My experience was scary. It highlighted the risks involved with this operation. In most cases, everything will be fine. My epidural with Jackson at Kapiolani Hospital on Oahu went perfectly (blog here). BUT, human error happens. We all make mistakes. Obviously, natural childbirth is the only way to assure this won’t happen to you.

 

Other blogs you may be interested in: 

Maui Memorial Hospital: Maternity Tour – What to Expect

Childbirth: Hospital Bag Checklist

Preparing Older Sibling for Baby on the Way

The 5 S’s “Happiest Baby on the Block” Works

Getting my Pre-Baby Body Back

My Favorite Affordable Maternity Clothes from Pink Blush Maternity

Jackson’s Birth Story

Early Signs of Pregnancy

Tips for Sleeping Comfortably While Pregnant

Our Birth Announcement Gender Reveal Parody Songs

 

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5 Responses

  1. crissy says

    I am so sorry to read of your horrid experience! Yet, so relieved to not be alone.

    I, too, am suffering from spinal headache (after csection). I received a spinal block on 4/14/16 & anesthesiologist took 3 tries to get my spinal block in. 12 hours later my debilitating migraine began. I spent the next two days on percocet, motrin, Tylenol, narcotic injections, in bed, fluid, not able to sit up,etc. NOTHING could touch this pain. I couldnt even open my eyes in the upright position. Laying down with an icepack was all I could do to be able to carry a simple conversation. I was convinced I would have a stroke. Finally, after 48 hours a nurse mentioned spinal headache. What is that!?

    I too researched like hell & when offered the blood patch, begged for it!

    Same anesthesiologist did the patch as did my spinal. Took him two tries :/.

    I had it done (ouchhhhhhhhh)!!!! & he had me lie flat for 30 minutes & then slowly lift my bed over two hours. My headache was GONE! I couldn’t believe it. I was released two hours later.

    Now, 2 days after, my headache is back. My ob says go back for a second patch. But, I don’t think it’s the best idea. However, I don’t want to be like this forever. I’ve read it will heal on its own (online). I’ve been told it will now be lifelong (by a nurse?) Dr. Says rest, hydration, caffeine & time.

    But, time is what I don’t want to waste with my new baby girl!

    Has your headache returned?

    • Malika says

      I’m so sorry you are going through that!! My headache has not returned – thank goodness! But I am also worried about the long term effects. I have a nagging pain in the middle of my back where I was poked and have to be super careful to engage my core whenever I get out of bed or move in a weird way. Good luck mama!

  2. Sarah says

    I’m so sorry you had to, and continue to go through, that pain!

    I had an intrathecal at Maui Memorial and it was not like that at all. I loved it because unlike the epi with baby #1, I could feel contractions and move my legs and I didn’t feel paralyzed like my epidural was. So yes, as you know, something went wrong. :(

    I’m SO sorry you had to go through that during what should have been such a special bonding time with your new little one. Glad you are healing. <3

  3. Anonymous says

    Would you be willing to share who the anesthesiologist was that did the procedure?

    • Malika says

      Message me directly on FB @MalikaDudley