b.cognosco
Where leaping to conclusions is my primary form of forward motion.
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Tuesday, May 15, 2007
Why You Need To Be As Smart As Your Doctor
In August of last year a 43-year-old woman undergoing chemotherapy treatment for nasal cancer died after receiving a massive overdose of the chemotherapy drug flourouacil. According to an Incident Report (pdf) issued by the Institute of Safe Medicine Practices Canada the dose was miscalculated by two different nurses and incorrectly programmed into an electronically-controlled pump. The woman was then sent home, where the pump poured four (4) days worth of drug into her in four (4) hours. [More...]
Terry Frazier at 2:38 PM
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Thursday, February 9, 2006
Got A Tattoo? You May Get to Have Natural Childbirth
All you hip, hot young things getting those spiffy tattoos on the top of your ass cheeks may be in for a surprise. Seems doctors are leery of poking a needle through tattooed skin and pushing it into your spinal column – the procedure used to numb your lower body during childbirth. I’m ambivalent about this and, honestly, find small tattoos in that area kinda sexy. But it is something to think about. Your doctor may not be as reasonable as the one quoted below. [via Waking Up Costs]
Are Lower Back Tattoos A Contraindication To Labor Epidurals?
My Google News section on 'epidurals' came up with an interesting hit: Lower-back tattoos are popular with women, but do they make having epidurals during childbirth more dangerous?. It's a very good question because, at least in my practice, lower back tattoos are extremely common in laboring women. So common, in fact, that Saturday Night Live has a commercial parody for a product called Turlington's Lower Back Tattoo Remover (quicktime | windows media).
I was taught to avoid putting an epidural needle through tattooed skin and have gone to great lengths to do so. For example, one patient had a very large tattoo of what appeared to be the face of the devil on her lower back. On closer inspection, I noticed that the devil's right nares (which was free of tattoo ink) was right over her L3-4 interspace. I wished I'd taken a picture of that epidural catheter snaking out of the devil's nose.
I can't seem to find much science on the subject save for one abstract which makes a very reasonable suggestion to avoid coring out tattooed skin by making a small incision, if necessary. This may sound like a lot of trouble, but all it takes is a 16 gauge (or similarly large) hypodermic needle inserted into the skin first, then the epidural needle through that 'incision'.
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