Tuesday, September 7, 2010

Talkin' Shoppe...Post Delivery Pain.

I just love "shop" so much better with an extra 'p' and an 'e' in it! Makes it feel so...so...old time candy store-ish, doesn't it?

Er...it doesn't? Well, never you mind then, you just carry on about your business like no one ever asked you your opinion of how "shoppe" makes you feel, m'kay?

So...story goes, the other night at work, I had to have "pain" talk with one of my patients. I once wrote a post about pain, in which I made a wish at the very end of it. Friends, I just had my wish granted!

And my eyes opened.

My patient was consistently rating her pain at a 9. Maybe an 8, if we were lucky. But, here's the thing...she was smiling, joking, talkative...and I was at a loss. We'd tried EVERYTHING short of being graphic with the pain scale.

Lemme tell you something...I'm a wimp.

Confrontation I do not like.

However, I realized that we needed to make sure we were on the same "pain scale page", so I sat down for a little heart to heart with her (all the while my heart was thumpa-thumpin' out of fear that I'd say something wrong!).

After our heart to heart (and YES! I even used the "if I ripped your arm off, beat you with it, and lit you on fire" part!!), her demeanor totally changed. She had MISUNDERSTOOD the pain scale!

I wonder how many other people thought a 10 was the worst pain THEY had ever been in...not the worst pain they CAN POSSIBLY IMAGINE?!

We were best buds after that, my patient and I. For real...we totally bonded and she felt so comfortable asking me questions...she was a blast. And, it turns out...we weren't doin' too bad of a job managing her pain!

The whole point of that loooooonnnnnnngggggggg drawn out story, was to talk pain relief after childbirth...weigh your options...have some ammo for when you're sore and achy.

Here's whatcha get:

1. A whole lotta nothin'. Yes, it's true...some people don't need anything. Lucky dogs. (Hint: Due to recent accrediting "rules", we are not allowed to let patients take their own medicine from home. I won't tell if you don't, but I took my own ibuprofen. Shhhh...you said you wouldn't tell. Heck if I was paying 6 bucks a pill when I had a perfectly good jar of ibuprofen in my cupboard at home!)

2. A little bit of somethin'. Most people, who have vaginal births (hmmmm...have I ever told you that I have no problem...none whatsoever, saying "vaginal"? It's just "vagina" that trips me up. Weird, I know.), can get by with a little ibuprofen or acetaminophen (aka: Tylenol). With c-sections, typically you need:

3. A little somethin' more. Almost always, with c-sections, and occasionally with vaginal births, you'll find yourself in need of a stronger med to have in your arsenal. It's at this point, that we'll give you...THE NARCS. Narcotics can be your friend...if they are very short lived and not abused, they can actually aid in your recovery, by allowing you to move around better.

We use a lot of Percocet at our hospital...it allows for dosing every 4 hours, whereas Vicodin (the next most popular) contains WAY more Tylenol, and people tend to reach their 24 hour Tylenol max quite quickly. And going over your Tylenol max isn't a good thing...you're liver may wage a revolt.

(I'll level with you here...more and more of our docs are refusing to prescribe narcotics for home use after a vaginal birth--unless you've had a MAJOR tear. I'd have to say, I tend to agree.)

4. Then, there is my "secret weapon". If you've only had one baby, chances are you will have no idea what I'm about to speak of. If you've had five, like me, you'll want to hug me and we can commiserate on this through tears of "oh dear GOD that was awful!!!".

Friends, I'm talkin' "after pains". Cramps.

Those suckers can be down right worse than labor those first few days.

Then those dirty, rotten, good fer nuthin' nurses have to come and mash on your belly. (Another secret forthcoming: After baby #5...my nurses would just ask me, "how's your fundus" [that's what we're feeling when we mash on your belly, your "uterine fundus", or the top of your uterus] when they were going to do my exam..."Oh, fine!!" I'd respond, all chipper like, as I felt a large gush of blood pour out of me...I'd do a quick check of my vitals, take note of my pulse, make sure I wasn't dizzy...yup, I was fine. I'll be DAMNED if I was letting anyone come near that agonizing ball of agony that was the cause of so much pain and agony!! But that's our little secret.)

Ack...digression!! Sorry...back to my secret weapon...HEAT. Yup. That's it. Just plain and simple, good ol' fashioned heat. Be it the tub or a warm blanket...it works. HOWEVER...I found a miracle.

A miracle in a little foil package in a box residing in the pharmacy section of your local WalMart.

Ahhhhhhhhhhhhh...wow. I believed I discovered them with my 3rd babe, and when I was packing for the hospital...the only thing I really took care to remember to pack, were those heat wraps. The "Back" style...in large (don't bother with the menstrual ones...they make sense, yes...but they don't pack enough heat!). Put that puppy on backwards (heat toward your tummy not your back) and wrap it around, and you're golden for hours.

You're welcome. Oh, psh, stop gushing! I know I just told you the best thing ever invented for post-delivery pain, but...gosh...now, you're making me blush! You know, it's nothing...just a little woman-to-woman recommendation.

Although...I do accept chocolate for sincere gratitude.


  1. "After pain"... maybe I won't have another baby! Chalk that up to just another thing nobody ever tells you!

  2. I had a vaginal delivery with #1, and hoping for the same with #2. I had to use the ibuprofen and the percacet together for about a week, and I continued the ibuprofen for about 2 weeks. But I have an extremely low pain tolerance, so that's probably why. And afterpains? you just made me weak at my knees.

  3. I'm bookmarking this to reread in January so I'm ready when Jellybean comes. If I managed a tooth implant and wisdom tooth extractions with just Novocaine I should be up there on the pain tolerance scale - right?

  4. I used those thermacare heat wraps when I had Erika, actually the hospital had them & gave me some to use & they were heavenly!!!! If they don't have them this time around I'll definitely be sending hubby to the store for some! Oh and don't forget about the morphine! I go from morphine to tylenol after my c birth! Percocet makes me sick to my stomach! :( I love your talking Shoppe posts! I just referred to the "what to pack" one yesterday before asking you my question on twitter! :)

  5. oooh, I remember those after pains!! UGH!

  6. It's a bit off-topic, but I think about it whenever I read your Talking Shop posts. I have to say that Labor and Delivery nurses are heaven-sent. With my first, they basically carried me through a cruel doctor, and an emotional labor (they had to induce because of preeclampsia, and I ended up with a c-section I didn't want, but ended up being inevitable). I won't ever forget the nurse holding my head, looking straight into my eyes and saying, "This isn't because you are tired and don't want to argue with the doctor anymore. I want you to feel sure that it's for the health of you and your baby, and nothing more." Then after my daughter was born, she took the time to visit her in the nicu. Heaven-sent, I say.

    With my second, which ended up being a failed VBAC, I had a wonderful doctor, doula and midwife (overkill? Perhaps), but it's really the nurse I remember. She immediately asked for my birth plan, then actually read it, something I'd never seen a doctor do. She was kind, realistic and is 100 percent the reason that I was able to greet my son with a smile on my face instead of tears in my eyes about another c-section.

    I've had babies in two different hospitals, two towns and two very different experiences, but the one thing that was the same was the Labor and Delivery nurses. So I have to conclude that you are all pretty awesome.

  7. i love these posts!! i have 32 days left until my due date and you are so so helpful! thank you!!!

  8. Oh my the after pains. Nobody warned me about them prior to having my 2nd child...come one sisterhood of mamas!

    So, good for you for posting this. If we have a #3 I'll have to remember the therma care heat pack trick!

  9. It's fun for me to read your 'shop talk' posts, as baby # 1 (for me, but number five for hubby!) is due in November and I have yet to take my childbirth classes .. so it's nice to have a little light shining in on what's coming! :)

    Hope you're doing well!

  10. UGH...the afterpains with #4 were BAD! and the fundus (never knew what it was called :) but I had a sweet young nurse I was her 1st patient and after shooting her with "stuff" while giving birth I swore she was trying to get back at me with all the pushing and shoving and rotating she was doing with my uterus...and the blood, oh the blood...it was like she was stepping on a huge packet of ketchup every 2 minutes when she made that blood gush out of there...finally after making me take medication and threatening something else an older, wiser nurse came in and told her that I had just delivered my 4th baby in 6 years and all that bleeding was normal!! Gotta love those young nurses :)
    love your talking shoppe posts! my4redheads

  11. after pain? AFTER???? I never heard of such a thing! I cant read these "shoppe" post anymore- they make me nervous to have kid!

  12. I love your Talk Shoppe posts and btw I find the extra p and an e so cute! Crazy enough I don't remember the nurses pressing on my abdomen to get the blood out. I do remember getting Tylenol and some other pain meds for my wonderful size 4 incision on the vagina! (lol) Sadly this was for both births. I think that was the worst part of the healing process were those stitches.
    I have to agree with some of the other ladies that the L&D nurses were the bomb. If it wasn't for some amazing ladies after the birth of my son I would have had a breakdown. I was so VERY happy with them I wrote the hospital 2 letters about those ladies.

  13. Percocet was my best friend!! Those after cramps were bad, especially while nursing!!

  14. "After pain" can be extremely painful, but I just wanted to mention that in rare cases it can be "something else." After I had my twins vaginally (my third and fourth babies), I had extremely bad pain that didn't go away for more than a week. I have a very high pain tolerance -- I delivered my first son without an epidural and he weighed almost ten pounds -- so I knew I wasn't just wimping out. My doctor kept rolling his eyes when I told him it was bad and he finally decided to check me out internally. It turns out that I hadn't been, in non-technical terms, "cleaned out" thoroughly! Once the doctor did that, I was cramping badly and went home and passed out with painkillers and a heating pad. But afterward, my pain was enormously relieved. So my point is that if a woman's instincts are telling her that her pain is more than normal "after pain," she should insist on being checked out just in case.

  15. I will totally be packing the heat pads for our next baby!!!! Wow oh wow - those cramps were unexpected after my second child....
    Thanks ;o)

  16. I totally forgot about heat for cramping. Dang, that would have come in handy with my 3 bouts of "after pains"! I sometimes use a heating pad for menstrual cramps and it really helps!

    Oh my...you have to pay for your pills in the U.S.?! It's all free up here in Canada baby!

  17. Hi! =)

    I'll just say quickly that I only read your pain scale story and had to comment to say thank you.

    I'm a student nurse just entering my third, and final, year of training and I have seen these kinds of things get overlooked. It's so so important to make sure your patients understand what is going on and what is needed from them.

    So, your story has reminded me to always be aware of that!

    Thanks! =D


  18. I never had after pains with E!?!? Crazy maybe? Lucky! BUT if I ever am fortunate to embark on that journey again be sure I will have some Therma care heat wraps just in case ;) Love the shoppe post!

    Hope the kiddos first day went well

  19. I am a c-sectioner myself. So, I don't know of any "normal" after pains. I'd say the not so comfy feeling of being sliced open is after pain enough for my taste ;)

    P.S. Finn II is totally settled in, and it was the best thing for us in the situation. It's crazy how quickly they worm their way into your heart.

  20. my key to pain relief afterwards is frozen maxi pads, AHHHHHHHHHHH which I would have known about them the first time.

  21. So, am I to understand that the post-baby evil belly squish is OPTIONAL!? So, like, say I've had a half dozen or so kids (not really, but close) and they come in and I say it's just going back to normal fine, per the cramping with nursing and gushing and all that and oh by the way being able to feel it myself? Because I honestly would rather deliver twins, vaginally, drug-free with the 2nd forceps assisted again ONCE A DAY for a week than have one squish session.

    I told a friend of mine who's pregnant with her first about the squish sessions (they leave that part out of child-birth classes, apparently) and she about called her doc and volunteered for a c-section.

    And I do think it's interesting about the pain-scale... I tolerate pain really well, so even if I'm in horrible pain (for me) I tend to go with a lower number on the REAL pain scale (like, 3) so people don't bug me about taking those expensive pills... boo to that! The only time I'm a 9ish is when I have a migraine. Sigh. Again, I'd rather do the twin thing I mentioned than have a migraine.

  22. Why did I never know about this!?! Oh my gosh, I cried so hard while trying to nurse my new babies because the cramping was so terrible, WY worse than contractions! Good to know something that might work! :)

  23. I am SO glad I just read this! The afterpains were basically nothing with my first, not a huge deal with my second, and the worst. thing. ever. after my third. And I had an unmedicated delivery. (I think it was mostly psychological..."The baby is OUT! I thought this was supposed to STOP!")

    (Do you mind e-mailing me your response? I'm afraid I'll miss it if it's on here. I know you are busy, though. It's crawleykj at insightbb dot com, if you can.)

    I am definitely taking some of those with me when I go into labor with #4. You are awesome!

    BTW, with 5 kids, what type of vehicle do you drive? I don't expect us to need to know this (our plan is for #4 to be all) but...accidents do happen. (Hence the reason #4 is on the way when #3 is only 7 months old - about 4 months early, according to our plan! LOL!)

  24. This has got to be the BEST POST EVER that I've read! I am sooo going to remember those heat packs for baby #4 (whenever we decide to go for another). Thanks for the tips!

  25. After pains OHHHHHHHHHHHHHHHHHHH yes my freind.
    Ibuprofen round' the clock for my 3rd (as I totally forgot to do that with #2 and dearly regreted it...) Heat wraps did not do squat for me. Bummer.
    Worse part was nursing those little ones as the AP would shoot through the roof and trully being a 9.5 ( I am a CCU RN and do know the rating verbal and non verbal!).
    Whenever #2 or 3 wailed to be nursed I was bawling my eyes out and squirming/crying/whimpering the whole time they nursed (I was telling them it was my tummy and not them who were making me cry , not knowing for sure if they would be scarred for life on nursing and stop). I still nursed them as I am a firm believer in nursing as long as possible (and I was not letting my stupid whimpiness get in the way of that, the 2 only time in life that I battled pain in victory even thought it was the worsest ever.by the way, I had 3 non medicated births by choice, don't ask).
    Thanks to my husband who just soothed me as much as he could and made sure I popped those Ibuprofen on the dot when they were due.
    Believe it or not he is the one who remembered me of the AP for #3 and pack the bottle on my bedside table!
    The good part, my fundus was back to less grapefruit size in 2 days, I repeat 2 days.So small my midwife was baffled, she could barely feel the top of it. So it does have its silver lining...


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