Epidurals

[Guest guest]

Dr Bhate,

One would think that this is really an Ayurvedic chat room, with all the

scientific info you portend to display !!

As much as it is important for a physician practising Western Medicine to

understand Ayurveda, or Acupuncture, it is also equally important for a

practitioner of the Alternative system to understand "modern medicene". So,

atleast this is a serious attempt to study the other side. I give you lot of

credit for this. However, you do not see me deriding the Alternative Medicine

practice or its science. I do see a lot of attempt to convince people that

"western Medicine" is absolutely bad only, such as in this column.

 

You have picked out all the negative things and lumped them together. Atleast

now you can make an attempt to study the positive things and present them in

your next column.

 

First of all, all the things that you have mentioned do not happen to every one,

or in the dosages given for labor epidurals. Are they possible ? Yes.

 

I am not sure how Medicine is practiced in India, ( having left India in 1974),

but every pregnant patient who visits a hospital, in the United States, is given

a "tour of the hospital", and they get to see and meet with the labor room, the

lady who helps with Lamazze, an Anesthesiologist, and their Obstetrician. All

thses questions are raised and there is an " informed consent". This process is

in the 6th to the 7th month of pregnancy, giving the family enough time to do

their research and come up with questions that can be answered at a subsequent

meeting or by telephone, and much before their delivery. There are a few "

walk-in" deliveries, but far and few.

 

No Epidural is thrust on any patient willy-nilly. Their lawyer will pursue us if

it is done so. So, it is only when requested by the patient, that an Epidural is

given, and all the points that you raise have also been raised by the medical

community to see if it is really beneficial to give an epidural and whether it

prolongs labor, or causes increased rate of C-Sections, or if there is any

adverse effect on the neonate. None of these issues are new and the articles you

"quote" are from the Annals of Western Medical Literature.

 

There are Epidural dosages for Surgical anesthesia or for C-Section, that differ

from that for a Labor epidural. The one for labor is much more dilute form and

is given only to lower the pain level and not to take it away totally. When and

if you do give larger amounts, all the things or some of the things that you

mention are possible. Please do not presume that everyone other than Medical

practitioners are looking at all these events. There is a tremendous amount of

self-scrutiny, scientifically and otherwise of all the things we do. Giving a

patient an epidural, if she is on Coumadine or with Harrington rods is ofcourse

very challenging. What would you do if you were in our shoes and the patient

requests it ? Would you just say --no, woman you suffer through this labor,

because some remote practitioner of alternative medicine does not think you need

it !!! we'll get sued for not providing appropriate care.

 

Its one thing to discuss this in vacuum, trying to look at all the negative

things and to try to prove that only one system is obviously so much better and

the other way is worse, and yet another to actually render care on a daily

basis. We do not do it once a month, and debate if it was worth it. We do it on

a daily basis, to several people , who request it themselves. Please give some

credit to it. Now, that you have aired your bias, and I have presented the other

side, please use your power of proper discrimination. I like your "scientific "

bent of mind.

 

It is just the same as JC trying to lambast the "Pharma industry" and is

promoting artifically manufactured Vitamin C or an extract of something or the

other by some other "pharma" industry, or the myth about stopping all natural

salt, which was debunked by the director of some other NGO as a total myth, and

perpetrated by people who have vested interests in something or the other. Let

us practise integrated medicine and not get carried away by all this bias.

It is very amusing to read all this "literature".

 

Durgesh Mankikar,MD

[Guest guest]

As someone who has actually had a labor and delivery

in a western hostpital I can say that they may not

twist your arm about having an epidural, but

childbirth has become something unatural. You are

treated as if women are not made to have babies and

that they want you to do it as quickly as possible.

The female human body is not respected for it's

capacity to have children. Nurses are not given the

training to support a women in her attempts to deliver

a child without drugs, or pitocin or anything else to

speed it up. We need to get back to respecting nature

and focus on being healthy people in general.

Nutrition, exercise and so on. But then I guess

Western medicine would go out of business. Where is

the money in healthy people, who eat correctly, don't

need or use drugs, nurse their children and are happy?

 

There is no money in it, so I guess it's business as

usual.

 

Lisa

[Guest guest]

Dr. Mankikar,

You must work in a really excellent hospital. Nothing you have said

relates to my or my friends' experiences in American hospitals with

respect to childbirth. Of course we were all in the lower income

brackets at the time and did not have good insurance. I have found

personally that the hospital experience in the US is only as good as

patients financial situation and sometimes even that is not enough to

ensure good treatment. Having a consent form shoved at you as a nurse

is telling you that anything other than an epidural will deform your

baby is not my idea of "informed."

 

I agree with you that medicine and alternative medicine should have

some evidence to back it up, and obviously the standards for evidence

have been slipping for some time as exampled by the recent flap about

the NSAID's and the FDA's impotence to do anything really useful with

the drug companies.

 

The thing I like about the ayurvedists as opposed to the allopaths I know is

that they do not pretend to know everything, they allow plenty of room for the

placebo effect (patient's own mind) to work without looking down at the people

it works on, and they tend to be unfailingly courteous and really listen to

their patients. They do not see us as the means to their next BMW or country

club membership and keep their prices and requests reasonable. In return, we do

not see them maybe as cynically as we would see one of allopaths, for example.

That may be a failing on the part of the patient to trust any doctor or vaidya

too blindly. One thing I have discovered as I have gotten older is that

frequently the body will heal itself no matter what the doctors do to it. Thank

all the gods for that.

Darla Wells