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Epidurals are a miracle technology

https://worksinprogress.co/issue/the-wonder-of-epidurals/
23•karakoram•2d ago

Comments

DivingForGold•2d ago
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.

brookside•55m ago
(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."

vitally3643•16m ago
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.

WarmWash•8m ago
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...
notnaut•4m ago
Medicare for all fixes a lot of the problems with the US health system!
Findecanor•39m ago
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.

Roark66•26m ago
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.
photonios•19m ago
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.
farhaven•6m ago
> 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.

InitialLastName•16m ago
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

clark_dent•6m ago
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.

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Epidurals are a miracle technology

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