Pregnant patient

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TPIs no local or local only; we use local for epidurals lidocaine in pregnancy; heat ice, stretching, proper pillow, sleep hygeine (side sleep), acupuncture not to cervix, water therapy, TENS used overseas, OMT/chiropractic care. To provide context only MVI are category A for the routine stuff. Lidocaine and APAP are category B ie animal studies not demonstrating harm. although there are studies that it increases miscarriage and ie defects and miscarriage in first trimester as well as childhood asthma and cryptorchidism. This review articles says probably okay if conservative measures and for good reason but doing it blind ie without fluoro or U/S if capable. Steroids category D meaning maternal benefit outweigh risk to fetus is reason.

Pain Management in Pregnancy: Multimodal Approaches - PMC

Nonobstetrical causes of pain during pregnancy are very common and can be incapacitating if not treated appropriately. Recent reports in the literature show that a significant percentage of pregnant women are treated with opioids during pregnancy. ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
 
Yea I was going to do some TPIs with local only. Curious if there was anything folks had done before for injections.
 
dipriMAN said:
Yea I was going to do some TPIs with local only. Curious if there was anything folks had done before for injections.
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How were u going to position her for the procedure? Prone seems like u would need some documentation
 
dipriMAN said:
Have a pregnant patient on the schedule tomorrow for back pain. Curious to here what people would be comfortable doing in terms of procedures or medications for these patients?
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Be band - elastic band that provides some support to the pelvis and back. Lidocaine only TPI. Even Tylenol now has some studies suggesting risk so on any meds I just tell them that they need to clear it with their OB.
 
painfree23 said:
Not getting opiates from me…not gettin surgery from me either.
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So your answer for a pregnant woman with an acute herniated disc and severe, debilitating pain is to suck it up?

You realize that oral steroids are category B and continued throughout pregnancy in woman with rheumatic disease?
 
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Baron Samedi said:
So your answer for a pregnant woman with an acute herniated disc and severe, debilitating pain is to suck it up?

You realize that oral steroids are category B and continued throughout pregnancy in woman with rheumatic disease?
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They are category D during first trimester, category C during 2nd and 3rd
1628299027683.png
 
soccrwz said:
TPIs no local or local only; we use local for epidurals lidocaine in pregnancy; heat ice, stretching, proper pillow, sleep hygeine (side sleep), acupuncture not to cervix, water therapy, TENS used overseas, OMT/chiropractic care. To provide context only MVI are category A for the routine stuff. Lidocaine and APAP are category B ie animal studies not demonstrating harm. although there are studies that it increases miscarriage and ie defects and miscarriage in first trimester as well as childhood asthma and cryptorchidism.
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I thought you were joking but apparently not...
 
Baron Samedi said:
So your answer for a pregnant woman with an acute herniated disc and severe, debilitating pain is to suck it up?

You realize that oral steroids are category B and continued throughout pregnancy in woman with rheumatic disease?
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painfree23 said:
Is that really worth the impending 18 year liability
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painfree23 said:
Not getting opiates from me…not gettin surgery from me either.
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Agree with pain free. I never see or would offer a procedure to a pregnant woman.

they decided to get pregnant, and must live with the consequences in today’s America.

unfortunately this legal situation is due to laws created and financed by personal Injury/malpractice lawyers and the Democratic Party, to which the majority of lawyers belong.

woman survived radiculopathy in pregnancy for thousands of years before the last 50 when IPM became an option, and will have to do so still, thanks to liberal bloodsucking lawyers.
 
bedrock said:
Agree with pain free. I never see or would offer a procedure to a pregnant woman.

they decided to get pregnant, and must live with the consequences in today’s America.

unfortunately this legal situation is due to laws created and financed by personal Injury/malpractice lawyers and the Democratic Party, to which the majority of lawyers belong.

woman survived radiculopathy in pregnancy for thousands of years before the last 50 when IPM became an option, and will have to do so still, thanks to liberal bloodsucking lawyers.
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Democrats are to blame?

didn’t we just hear a story how republicans made law allowing that Alabama mom to be charged with a felony for taking a prescribed opioid during pregnancy, opening the door to charge doctors with a felony of prescribing medicine to a pregnant patient …
 
dipriMAN said:
Democrats are to blame?

didn’t we just hear a story how republicans made law allowing that Alabama mom to be charged with a felony for taking a prescribed opioid during pregnancy, opening the door to charge doctors with a felony of prescribing medicine to a pregnant patient …
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I completely disagree with that law as well.

But lack of tort reform, and million dollar judgements for slipping, hot coffee, or malpractice wins against physicians who did nothing wrong, yes the overwhelming majority of those legal situations and laws are enacted by democrats and the legal profession donates heavily to democrats, who create and pass such laws.

why do you think the one of the only states with true tort reform and protection against baseless lawsuits is Texas, Historically one of the reddest states?

Not a coincidence that none of deep blue states have real tort reform to prevent liberal bloodsucking lawyers from destroying lives and business with baseless lawsuits that would be laughed out of court in other countries.

you can thank your local democratic representatives for that.
 
Baron Samedi said:
Every ****ing thread...
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So sorry that your mom never taught you to admit when you were wrong.


Can be frustrating to have to learn as adult, so you respond with anger, instead of maybe, just maybe, learning something.

But then again, some people of certain persuasion prefer to live in an echo chamber were everyone repeats the same things to each other instead of learning to think independently for themselves. And since they can't intellectually defend their opinions, they resort to anger and cursing.
 
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bedrock said:
So sorry that your mom never taught you to admit when you were wrong.


Can be frustrating to have to learn as adult, so you respond with anger, instead of maybe, just maybe, learning something.

But then again, some people of certain persuasion prefer to live in an echo chamber were everyone repeats the same things to each other instead of learning to think independently for themselves. And since they can't intellectually defend their opinions, they resort to anger and cursing.
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this statement might be akin to "the pot calling the kettle black"
 
bedrock said:
I completely disagree with that law as well.

But lack of tort reform, and million dollar judgements for slipping, hot coffee, or malpractice wins against physicians who did nothing wrong, yes the overwhelming majority of those legal situations and laws are enacted by democrats and the legal profession donates heavily to democrats, who create and pass such laws.

why do you think the one of the only states with true tort reform and protection against baseless lawsuits is Texas, Historically one of the reddest states?

Not a coincidence that none of deep blue states have real tort reform to prevent liberal bloodsucking lawyers from destroying lives and business with baseless lawsuits that would be laughed out of court in other countries.

you can thank your local democratic representatives for that.
Click to expand...
I am very not up to date on this topic, but don’t Massachusetts and California have similar tort reform?

I heard someone say something about not needed malpractice in NYC for some strange reason I didn’t quite understand, something to do with this.
 
dipriMAN said:
I am very not up to date on this topic, but don’t Massachusetts and California have similar tort reform?

I heard someone say something about not needed malpractice in NYC for some strange reason I didn’t quite understand, something to do with this.
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not really

"With some exceptions, plaintiffs in medical malpractice lawsuits in Massachusetts cannot recover more than $500,000 in non-economic damages. Meanwhile, economic damages for medical malpractice in Massachusetts are not capped."

Boston Damage Caps Attorney | Boston Medical Malpractice Lawyers

Free Consultation - Boston Medical Malpractice Lawyers Jeffrey Glassman Injury Lawyers - Boston Damage Caps Attorney
www.jeffreysglassman.com www.jeffreysglassman.com

then again, this is from the website of an ambulance chaser
 
bedrock said:
So sorry that your mom never taught you to admit when you were wrong.


Can be frustrating to have to learn as adult, so you respond with anger, instead of maybe, just maybe, learning something.

But then again, some people of certain persuasion prefer to live in an echo chamber were everyone repeats the same things to each other instead of learning to think independently for themselves. And since they can't intellectually defend their opinions, they resort to anger and cursing.
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from your posts, i learned that calling the boy scouts to cut your lawn is a pretty dumb idea
 
bedrock said:
I completely disagree with that law as well.

But lack of tort reform, and million dollar judgements for slipping, hot coffee, or malpractice wins against physicians who did nothing wrong, yes the overwhelming majority of those legal situations and laws are enacted by democrats and the legal profession donates heavily to democrats, who create and pass such laws.

why do you think the one of the only states with true tort reform and protection against baseless lawsuits is Texas, Historically one of the reddest states?

Not a coincidence that none of deep blue states have real tort reform to prevent liberal bloodsucking lawyers from destroying lives and business with baseless lawsuits that would be laughed out of court in other countries.

you can thank your local democratic representatives for that.
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I’m a red blooded conservative. But I can’t place the blame solely on Dems for trial lawyers running rampant. The GOP never even tried to pass tort reform when they had all of congress and the WH. Prolly cause reps and Dems were mostly all lawyers prior to politics. They both bow to the altar of trial lawyers and neither side truly wants it to go away on a national level
 
Ducttape said:
this statement might be akin to "the pot calling the kettle black"
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Not sure why you felt the need to reply simply to get in an dig, except due to frustration that you've never come close to defeating me in an intellectual debate.

Please go back to your echo chamber now, where it is safe and warm.
 
SSdoc33 said:
not really

"With some exceptions, plaintiffs in medical malpractice lawsuits in Massachusetts cannot recover more than $500,000 in non-economic damages. Meanwhile, economic damages for medical malpractice in Massachusetts are not capped."

Boston Damage Caps Attorney | Boston Medical Malpractice Lawyers

Free Consultation - Boston Medical Malpractice Lawyers Jeffrey Glassman Injury Lawyers - Boston Damage Caps Attorney
www.jeffreysglassman.com www.jeffreysglassman.com

then again, this is from the website of an ambulance chaser
Click to expand...


dipriMAN said:
I am very not up to date on this topic, but don’t Massachusetts and California have similar tort reform?

I heard someone say something about not needed malpractice in NYC for some strange reason I didn’t quite understand, something to do with this.
Click to expand...

geauxg8rs said:
I’m a red blooded conservative. But I can’t place the blame solely on Dems for trial lawyers running rampant. The GOP never even tried to pass tort reform when they had all of congress and the WH. Prolly cause reps and Dems were mostly all lawyers prior to politics. They both bow to the altar of trial lawyers and neither side truly wants it to go away on a national level
Click to expand...

personal injury and other frivolous lawsuits are a similar political situation to health insurance, and other medical legislation.

Republicans are not completely innocent either, and can not be relied on to protect healthcare or to protect the legal system from imploding due to ridiculous lawsuits.

That said, the biggest enemies to both medicine and common sense law, (which would throw out frivolous lawsuits, and onerous business regulation stifling the economy) are democrats.
 
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SSdoc33 said:
from your posts, i learned that calling the boy scouts to cut your lawn is a pretty dumb idea
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Why is exactly is that a dumb idea? Because a high percent of boy scouts might have morals taught to them in their youth so they are respectful, dependable, and grateful for the chance to make some summer spending money at age 14?

Feel free to continue using your local lawncare service full of hard drinking high school dropouts for $100 a session instead of a supporting a responsible young kid for $10 a mow.
 
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bedrock said:
Why is exactly is that a dumb idea? Because a high percent of boy scouts might have morals taught to them in their youth so they are respectful, dependable, and grateful for the chance to make some summer spending money at age 14?

Feel free to continue using your local lawncare service full of hard drinking high school dropouts for $100 a session instead of a supporting a responsible young kid for $10 a mow.
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look, i'd love to pay a kid 10 bucks to mow my lawn.

but its not the 80's anymore. kids won't do it. boy scouts definitely won't. you'd have to sign some liability waiver. the kid would be in coding camp or jiu jitsu practice, or whatever. the parents also wouldnt let it happen. here and there maybe, but it is not like it used to be.
 
SSdoc33 said:
look, i'd love to pay a kid 10 bucks to mow my lawn.

but its not the 80's anymore. kids won't do it. boy scouts definitely won't. you'd have to sign some liability waiver. the kid would be in coding camp or jiu jitsu practice, or whatever. the parents also wouldnt let it happen. here and there maybe, but it is not like it used to be.
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Agree it’s no longer the 80s and far fewer kids have summer jobs these days instead of padding their college applications with BS field trips to third world countries, where they can say they “learned so much” from their 10 days there, before going back to their cushy overprotected life.
However this work ethic and instilling youth with responsibility and respect does still exist in the Rocky Mountain West of Idaho, Montana, Wyoming, Colorado, Utah, etc. and a few other states as well.

But probably not in the Chicago/DC/LA/SF/NYC suburbs.

I know which of those areas I’d prefer to raise children and be proud of what they eventually become.
 
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bedrock said:
Agree it’s no longer the 80s and far fewer kids have summer jobs these days instead of padding their college applications with BS field trips to third world countries, where they can say they “learned so much” from their 10 days there, before going back to their cushy overprotected life.
However this work ethic and instilling youth with responsibility and respect does still exist in the Rocky Mountain West of Idaho, Montana, Wyoming, Colorado, Utah, etc. and a few other states as well.

But probably not in the Chicago/DC/LA/SF/NYC suburbs.

I know which of those areas I’d prefer to raise children and be proud of what they eventually become.
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Do you have kids?
 
bedrock said:
Agree it’s no longer the 80s and far fewer kids have summer jobs these days instead of padding their college applications with BS field trips to third world countries, where they can say they “learned so much” from their 10 days there, before going back to their cushy overprotected life.
However this work ethic and instilling youth with responsibility and respect does still exist in the Rocky Mountain West of Idaho, Montana, Wyoming, Colorado, Utah, etc. and a few other states as well.

But probably not in the Chicago/DC/LA/SF/NYC suburbs.

I know which of those areas I’d prefer to raise children and be proud of what they eventually become.
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Haha after the kids mow your lawn do you ask them to get off of it 😉
 
bedrock said:
Agree it’s no longer the 80s and far fewer kids have summer jobs these days instead of padding their college applications with BS field trips to third world countries, where they can say they “learned so much” from their 10 days there, before going back to their cushy overprotected life.
However this work ethic and instilling youth with responsibility and respect does still exist in the Rocky Mountain West of Idaho, Montana, Wyoming, Colorado, Utah, etc. and a few other states as well.

But probably not in the Chicago/DC/LA/SF/NYC suburbs.

I know which of those areas I’d prefer to raise children and be proud of what they eventually become.
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i remember when i used to be idealistic like this. i used to think i could control my kids, their environment, what type of person the grow up to be.

then i had 3 of them and i realized that they control me. you roll with the punches and try to keep them from jumping in front on oncoming traffic, sticking a fork in their eye, and dumping pure granulated sugar down their throat.
 
SSdoc33 said:
i remember when i used to be idealistic like this. i used to think i could control my kids, their environment, what type of person the grow up to be.

then i had 3 of them and i realized that they control me. you roll with the punches and try to keep them from jumping in front on oncoming traffic, sticking a fork in their eye, and dumping pure granulated sugar down their throat.
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It had better be gluten free sugar
 
You want your lawn mowed, don't hire an illegal alien, or "undocumented immigrant" if you prefer, to do it under the table. Don't try to get poor-paying child labor either unless they offer. Either hire a proper lawn company or do it yourself. Or better yet, replace the lawn with a low-maintenance natural landscape that supports wildlife and save the environment while you're at it.
 
bedrock said:
Not sure why you felt the need to reply simply to get in an dig, except due to frustration that you've never come close to defeating me in an intellectual debate.

Please go back to your echo chamber now, where it is safe and warm.
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your comments are nonsequitor and frankly incorrect.

in addition, on multiple threads, particularly on this other forum, there are multiple "echo chamber" threads by conservative members that I stopped correcting for this exact reason.


there is no necessity to bringing up politics in a thread about procedures on pregnant women.
 
Ferrismonk said:
You want your lawn mowed, don't hire an illegal alien, or "undocumented immigrant" if you prefer, to do it under the table. Don't try to get poor-paying child labor either unless they offer. Either hire a proper lawn company or do it yourself. Or better yet, replace the lawn with a low-maintenance natural landscape that supports wildlife and save the environment while you're at it.
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I've been looking into this xeriscape but have to navigate the neighborhood HOA rules. I find my lawn a waste of water, energy, and money with minimal return.
 
ragnathor said:
I've been looking into this xeriscape but have to navigate the neighborhood HOA rules. I find my lawn a waste of water, energy, and money with minimal return.
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the hell you say!!!!

my lawn is the only thing in my life that i have any control over. that 1 hour of lawncare a week is a non-nagging, non-complaining hour of bliss. just dont step on it or god forbid park your car on it or there will be hell to pay. watching my wife's friends try to back their gigantic SUVs out of my driveway gives me heart palpitations.

also, this helps:

1628619735592.png
 
get the standing version SSdoc, better on your back
 
cowboydoc said:
You'll have to move to flyover country to be able to buy enough land to turn that thing around! I don't think a Prius would pull that.
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how the eff did you know about the prius? did i mention it? did it just fit my persona? both?
 
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